Talk:Homeopathy/Archive 13: Difference between revisions

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


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


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


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


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


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


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


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


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


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


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


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


== Discussion of ground rules and other issues ==


I have removed the text below from the article, as the statements are not supported by the reference; an online link to it is now in the article. In addition, I have posted an article on [[Oscillococcinum]].
Howard, you gave the wrong link for Sympathetic magic. It's http://en.citizendium.org/wiki/Sympathetic_magic  And make sure the period at the end does not get connected to the link. [[User:Chris Day|Chris Day]] 15:26, 16 December 2009 (UTC)


<blockquote>Some [[randomized controlled trial]]s that have tested the efficacy of homeopathic medicines have reported  positive results, but, as mainstream physicians contend that large randomized controlled trials have generally not shown effectiveness beyond [[placebo]] effects, except for the fact that four large trials (totaling 1,194 patients) have found efficacy from [[Oscillococcinum]] 200C in the treatment of influenza.</blockquote>
That's a reasonable way to look at it, which is unusual for a blog. [[User:D. Matt Innis|D. Matt Innis]] 18:43, 16 December 2009 (UTC)


The text above is somewhat hard to parse, and the statistical data is a bit more than "mainstreams physicians contend."  It also does not reflect the studies. There were seven, not four, trials. Four were of treatment and three of prevention; the 1,194 figure above only reflects the treatment trials, not the prevention trials in 2,265 patients.
::Put it into the External Links. --[[User:Daniel Mietchen|Daniel Mietchen]] 19:27, 16 December 2009 (UTC)


It was the conclusion of the Cochrane reviewers that only two of the studies were statistically adequate. Looking at all seven, however, they concluded Oscillococcinum had no preventive effect, but showed enough treatment effect to warrant further studies. They did not consider it ready to recommend as first-line therapy.
== Ramanand's changes  ==


I have also removed from the article
First, the word " most <u>biased</u> medical " is argumentative, does not fit the language of the lede, and is clearly advocacy.
<blockquote>Homeopaths counter that the vast majority of these larger trials tested a single remedy given to every patient without any individualized treatment, suggesting that these larger trials did not maintain external validity to the system of homeopathy and are therefore not valid tests of it.</blockquote>


If there is a specific homeopathic publication or presentation that counters these specific findings, it should indeed be in the article, with sourcing. The text above, however, implies that homeopaths reject the specific Cochrane study, but give no specific arguments against it.
The statement supporting homeopathy in the lede, even if the references were solid, belongs, stylistically, in a later section on the mechanisms of homeopathy. One reference is, as far as I can tell, from a Brazilian university with a site in, presumably, Portuguese, which I do not read. We generally don't use non-English references, especially when they are not clearly from peer-reviewed journals or otherwise reviewed sources.  


I'm honestly puzzled, and would appreciate being educated, on why homeopathic remedies, based on symptoms, would be used as preventive measures. Honest question: does homeopathic theory say that the administration of a remedy will prevent, as well as treat, the symptoms in question? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:35, 20 October 2008 (UTC)
The other reference is from Khuda-Bukhsh, whom, I believe, has been in the memory of water controversy, is a review of possible molecular mechanisms of action. On first glance, it's an interesting paper, but does not talk at all about efficacy &mdash; just how homeopathic remedies may work, if they work. It doesn't belong in the lede, although it's not unreasonable to use it as a reference in a later section.


:Thanx Larry. I am not at all clear how much of your comments are directed to me or to other people here. To date, I have not engaged in any edit wars, and although I have occasionally deleted some material, I always try to add comments and discussion.  If and when I err here, please alert me. That said, our lead previously made four references to mainstream doctors not accepting homeopathy.  This redundancy, within a short section, seemed non-encyclopedic.  Heck, one could choose to have a "skeptical" comment after every sentence here, but needless to say, that would be too too much.  Let's seek a middle ground.
Neither addition works where it is. The first is advocacy and non-neutral. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:45, 7 January 2010 (UTC)
:The use of "biased" is definitely adversarial. [[User:Chris Day|Chris Day]] 21:12, 7 January 2010 (UTC)
:With regard to the rebuttal (it works, and we know how), I am loath to see this article head down the direction of he says, she says tit for tat. [[User:Chris Day|Chris Day]] 21:21, 7 January 2010 (UTC)


:As for the term "skeptic," I do not see that it is prejorative (in fact, many skeptics of homeopathy are very proud of their skepticism). I personally think that the term is simply descriptive of some people's attitude towards the subject of homeopathy...and it would seem that "mainstream physicians" is not an adequate description of the variety of people who are skeptical of homeopathy.
::The whole article is full of oxymorons, containng both viewpoints, so I don't see anything wrong with what I've inserted, unless the critics' statement is also removed (about what scientists feel). I'm fine if the word <u>biased</u> is removed, if it seems adversarial. The Portuguese and French is only in the references section and shouldn't be a problem.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 10:28, 8 January 2010 (UTC)


:As for Howard's statement above, the written info on Oscillococcinum in this article is correct.  I didn't highlight the "prevention" studies because the subject at the time was "large trials" that had a positive result for this medicine.  The preventional trials did not have a positive result, while the treatment trials all had a positive result. As for prevention trials, I do not at present see any statement in our article that says or suggests that homeopathic medicines have been shown to "prevent" a specific disease. [[User:Dana Ullman|Dana Ullman]] 00:28, 21 October 2008 (UTC)
:::Well, Ramanand, the general CZ, policy, especially in the Charter, is that articles don't equally present all views. They present the preponderance of the expert views, and, in this case, the experts are in health sciences; there isn't a unifying discipline among healing arts. Not all healing arts support homeopathy.


:::Re the term "skeptic" and "skepticism," I am going to have to disagree and insist that we use another term. Again, Dana, the point is that ''the other side rejects the term,'' because it is used in a way that implies that there is some presumption in favor of homeopathy.  Suppose a creationist, or a tarot card reader, or some other view you had little respect for, were to insist on labelling the critics of the views as "skeptics" and never as "scientists"; they would prefer to be describe not according to their attitudes to the subject matter, but according to their qualifications: they are scientists. Let's be very clear. This is an expert-guided encyclopedia and it reflects the mainstream, expert view first and foremost.  For that reason alone, any presumption is frankly ''not'' in favor of homeopathy.  That is ''why'' it is crucial that there be critical remarks from the point of view of, indeed, mainstream medicine throughout the article.  This should not be done in a way so as to interrupt the flow of the narrative, or make it impossible to state the view of homeopathy clearly and even sympathetically.  Again, when the back-and-forth in the text of the article occurs, it should be as clear as possible to the reader that such a critical discussion is not done in order to recommend or refute any view of the subject, but in order to give the reader both maximum information and a robust sense that he may make up his own mind as unincumbered as possible by ''any'' dogma.
::::Everyone needs to [[CZ:Neutrality Policy|Neutrally]] present all views. [[User:D. Matt Innis|D. Matt Innis]] 02:31, 9 January 2010 (UTC)


:::Let's think creatively about other possibilities we might be able to agree upon, ''please.''  I am partial to "mainstream physicians," which is precisely descriptive.  "Skeptical mainstream physicians" might work as well.  But maybe another word or phrase entirely, like "Critics in the mainstream health community" and the like. --[[User:Larry Sanger|Larry Sanger]] 03:57, 21 October 2008 (UTC)
::The foreign language citations have been a problem in many other articles, not just here.  


::There is a major controversy in evidence-based medicine over the selective publishing of trials. There is a particular sensitivity about sponsors deciding not to publish results that showed no efficacy, not just where there were no side effects. AIn this specific case, the Cochrane (i.e., Vickers and Smith) meta-analysis addressed both prevention and treatment trials. If the present article does not mention prevention trials, yet there were sufficently large studies to justify meta-analysis, that seems a deficiency in the article. While you might not be using homeopathic preparations for prevention, there are a substantial number of published studies that do. You may not be saying that medicines prevent things, but there are clearly homeopaths who do, and who have conducted trials to investigate that.  
:I think you mean contradictions or rather or challenges, not oxymorons. An oxymoron would be a "heroically large dose of a homeopathic simillum." An oxymoron is a contradiction in terms.


::Stevinson and colleagues published "Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery" [http://jrsm.rsmjournals.com/cgi/content/abstract/96/2/60]. Jacobs ''et al.'' published "Homeopathy for Attention-Deficit/Hyperactivity Disorder: A Pilot Randomized-Controlled Trial" [http://www.liebertonline.com/doi/abs/10.1089/acm.2005.11.799?cookieSet=1&journalCode=acm]]. A meta-analysis of "Homeopathy for Childhood and Adolescence Ailments" specifically addressed prevention as well as treatment [http://www.mayoclinicproceedings.com/pdf%2F8201%2F8201a7.pdf]].
:Sorry, I'm in favor of removing both additions. You will need to face the reality that the article will not be as pro-homeopathy as you want, just as others wish it weren't here at all. It's a compromise. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:48, 8 January 2010 (UTC)


::Need I add more citations to demonstrate that if the article does not discuss homeopathic approaches to prevention, the problem is in the article's coverage? I'm not making any judgment if these studies showed benefit or not. The point is, Dana, that if there is significant homeopathic work in any area, that needs to be covered in the article about what homeopathy '''is''', rather than how it is criticized. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:01, 21 October 2008 (UTC)
::I applaud, encourage and appreciate collaborative efforts to work toward improvements, but I think this lead still needs significant work to add any substantial improvement to the approved version's lead. [[User:D. Matt Innis|D. Matt Innis]] 02:28, 9 January 2010 (UTC)


This article should be <blockquote>about what homeopathy '''is''', rather than how it is criticized.</blockquote>. I'm wondering what was wrong with <blockquote>Homeopaths counter that the vast majority of these larger trials tested a single remedy given to every patient without any individualized treatment, suggesting that these larger trials did not maintain external validity to the system of homeopathy and are therefore not valid tests of it.</blockquote>which Dana had inserted?&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 02:52, 21 October 2008 (UTC)
:::I forgot to wish all of you a Happy (belated) New Year. The presently approved article's Lead isn't 'neutal' at the moment. It should either explain homeopathy plainly or if y'all want criticism in the Lead, it should contain both viewpoints. Where's Dana, by the way, in Germany again?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 09:14, 9 January 2010 (UTC)


:::What is wrong? It says, in very, very general, nonquantitative terms, that homeopaths don't like trials. It doesn't say how homeopathy can be validated beyond "trust me".  There are statistical methods for testing individualized therapies, used in fields beyond homeopathy, but there has been no response, by homeopaths, to descriptions of such methodology. It states nothing positively about homeopathy, just negatively about [[evidence-based medicine]]. Please don't bring up the argument that people who haven't tried it can't judge it; that is meaningless.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:02, 21 October 2008 (UTC)
:::: Happy New Year to you, too! Please let me know where you think the present Approved version lead (as opposed to the draft lead) is lacking and I'll be glad to take a look.  Dana approved the current lead, too, but I'm sure he'd take a look if we asked him. [[User:D. Matt Innis|D. Matt Innis]] 15:00, 9 January 2010 (UTC)


:::Howard, I really don't have the time (I really don't). I'm sure there are statistical methods for testing individualized therapies with respect to homeopathy; for a change why don't you look for those on the Net and include it/them here?&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:15, 21 October 2008 (UTC)
:::::I'd posted a whole lot of links to homeopathic articles, late last year, but did not have the time to add it in the article. I was expecting someone here to do it, but no one did (not even Dana)! I already wrote what I wanted above, "It should either explain homeopathy plainly (without criticism in the very 1st sentence) or if y'all want criticism in the Lead, it should contain both viewpoints."—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:34, 12 January 2010 (UTC)


::::First, Gareth and I already discussed such methods as used for [[pharmacogenomics]], and no homeopath responded. Second, why should I go searching for proof that homeopathy is statistically effective? How did it become my problem to prove the homeopathic position from a scientific standpoint?
::::::We certainly can't add every link ever written to this article.  This is the overview article in an encyclopedia type format and summarizes homeopathy pretty well, I think.  Again, don't confuse the lead in the Draft with the lead in the main [[Homeopathy]] article.  I agree the lead in the draft needs more work and is not an improvement in its current form. [[User:D. Matt Innis|D. Matt Innis]] 12:45, 12 January 2010 (UTC)


::::You say you are sure there are such methods. Why are you sure? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:20, 21 October 2008 (UTC)
:::::::If nothing else, bibliographic links not directly related to the text belong on the bibliography page, preferably in articles. Also, in other articles, there is some selectivity. In some cases, reviews are more appropriate than small primary studies. In other cases, peer review and responsible publications are appropriate. In yet other cases, there is more leeway on publications but the reason needs to be explained.


::::I probably di'n't have time to see it. I was '''requesting''' you to do so because you have more time than me to do these things. I did see something at, 'http://www.guna.it/eng/ricerca/indice.htm'. There are other such things/sites which I don't have time to look into. Please do the needful. I'm sure you can improve this article by doing so.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:34, 21 October 2008 (UTC)
:::::::It's not necessarily reasonable to assume someone else will edit and add articles with which they aren't familiar, or with which they might disagree.  


:::::I'm really confused. Why should I do the research to support your point of view, when I haven't seen much evidence that it works? The reason I spend time on this is for the good of Citizendium's quality, not to be an advocate for homeopathy. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:38, 21 October 2008 (UTC)
:::::::What principles of homeopathy are in not in the lead?  It should go without saying that homeopathists believe what they are doing, or the article wouldn't be here at all. Having a small number of dissenting comments from people who question hematology simply establish it isn't universally accepted, and the details and pros and cons should be in the article, but later. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:27, 12 January 2010 (UTC)


:::::It' only for the good of Citizendium's quality that I'm '''requesting''' you to do so. I also hope that you can include some matter from the memory of water article in the 'Scientific basis of homeopathy' section to make it more neutral. I also feel that you should reintroduce the sentences where the term, 'skeptic' was used - neither Larry nor I consider that term pejorative/deprecatory. Thanks in advance for all the help.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 04:06, 21 October 2008 (UTC)
::::::::RE: provided references from Ramanand, [http://en.citizendium.org/wiki/Talk:Homeopathy/Archive_11#Long_time_no_see_.28post.29.21 this must be the list] and I do remember it, but it's mostly primary research.  They could be used for a more detailed article to support a specific claim where reviews aren't available, but to cite them here would result in too much detail for the general nature of this article. Primary research doesn't belong in a bibliography either.  I'm not sure that we have a subpage that would be appropriate for primary research, though it's an interesting idea for some other project, or way in the future for this one.  Otherwise, I'd think it would be a problem with [[CZ:Maintainability]]. There are other sites that do list all the research for each particular subject. [[User:D. Matt Innis|D. Matt Innis]] 14:51, 12 January 2010 (UTC)


::::::Perhaps I'm confused, but Howard, it sounds to me as if Ramanand is insisting that his view, probably shared by Dana and other homeopaths, be permitted to be included in the article. Are you ''actually'' saying that, no matter how confused or misleading their view is, you have decided it can't be included?  Surely you aren't saying that, but then I can't figure out what you are saying.
:::::::::This is one page ([[Homeopathy/Trials]]) that exists with a tabulated summary of some of the voluminous primary literature. I agree maintainability is an issue.  I bet there are hundreds of articles like this and the main problem is reducing it to the most important articles in the field. If that could be done well it might make a good catalog. [[User:Chris Day|Chris Day]] 17:18, 12 January 2010 (UTC)


::::::Perhaps it would be better to work with them on a clarified version of the claim ''and then,'' when it's as clear as it can be made, you simply add a sentence or two explaining how mainstream medical researchers would (or do) respond to such a sentiment.  What's wrong with that? In fact, isn't that what our neutrality policy requires? Maybe I'm confused, it is a little late. --[[User:Larry Sanger|Larry Sanger]] 04:02, 21 October 2008 (UTC)
:::::::::Matt, I made some time to read the entire (presently) approved article. I don't see any sentence saying there is evidence for homeopathy (the feg pdf document I've inserted in the present draft is accepted by 'mainstream' scientists as well). I object to the term 'placebo' in the lead (Edzard Ernst is known to be a ridiculed homeopathic baiter in the U.K.). I also object to the term 'fraud' in the Overview section<blockquote>They also are interested in whether positive results against expectation sometimes reflect manipulation of data or perhaps even fraud. </blockquote>. Like you said, can we edit the (presently) approved article?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 17:34, 23 January 2010 (UTC)
:::::::::David (Ellis), can you please tell me what objections you have to the feg pdf document?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 17:42, 23 January 2010 (UTC)


::::::Larry, Howard - that is what all of us want, i.e.both sides views should be incorporated in this article. Howard relatively has a lot of time, so I was hoping he could improve the article by incorporating both sides views.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 04:11, 21 October 2008 (UTC)
(undent)
Placebo in the lead is perfectly appropriate; conventional medicine routinely accepts the placebo effect as a component of therapies.


:::::::No, I don't think all of us want. Homeopathy is not a mainstream opinion. If the homeopaths want to put out their view, and accept that it simply does not have reasonable support by the criteria that would be applied to any medical therapy, fine.  
Fraud is mentioned gently as a possibility by some observers, seemingly far more gently than some of the homeopathic claims of the danger of medicine. Sorry, it's not unbalanced. Please do not go to "known" homeopathic baiters anywhere, else that you start having people bring in medical baiters from homeopathy. The problem with bait is that it often has a hook inside.


:::::::I don't see an equal set of views. One has testable models and consistent scientific theory. One has vitalism and spirit forces. It seems rather like religion and science; they are completely different models of thinking. As far as I can tell, you want homeopathy to be accepted on faith and testimonials. I have no idea how to improve something that has yet to give me any plausible reason that it works in any explainable way. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:29, 21 October 2008 (UTC)
By edit the presently approved article, no, other than for typos, it's frozen. It is possible to edit the draft, and eventually to have the edited draft become the newly approved.  


{{nocomplaints}} (I removed a comment that concerned the qualifications of others to participate here.  This sort of comment is contrary to [[CZ:Professionalism]].)
Again, what specific principles of homeopathy '''are not'' in the lede? --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:03, 23 January 2010 (UTC)


::::::::I agree with your attitude on the merits of the issues 100%, Howard.  That said, I'm afraid you have missed my point.  I am not asking you to endorse the position that "there is an equal set of views here," whatever that might mean precisely.  I am asking you to ''let homeopathy state what you regard as nonsense.'' You lack the right to prevent Ramanand and Dana from expressing some view, even if it is a nonsensical view, of mainstream science and trials and so forth.  But I frankly don't understand why you don't simply say, "Fine, now let me explain how mainstream science ''responds'' to that." After all, that is what you are, quite irrelevantly, insisting on so strongly here on the talk page.  If so, then let them have their say, and (essentially) say what you say in response to it ''in the article.''
:Friends, it has been a while since I check-in here.  I have not re-read most of the new draft, but I can tell you that I do not like the lede paragraph.  It is simply not encyclopedic or impartial.  Anyway, we only recently spent a lot of time approving the previous edition.  I suggest that we let it sit for 3-6 months or more before we re-do it.  [[User:Dana Ullman|Dana Ullman]] 05:28, 1 February 2010 (UTC)


::::::::The neutrality policy means you ''cannot'' speak only for yourself here; you speak for everyone, including your intellectual sparring partners.  You ''must'' try to express the homeopathic view as sympathetically as possible--while expressing the mainstream reaction to it as sympathetically as possible as well.
::Dana, I hope you can insert sentences that read something like, "there is scientific evidence for homeopathy", using the PDF for "Scientific framework of homeopathy: evidence-based homeopathy" available at http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/286/354 wherever appropriate.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:21, 2 March 2010 (UTC)


::::::::And this goes for ''both'' sides.  I am tempted to remove everyone who has been disputing from this article for a time, and let others have a crack at it, simply on grounds that there is good evidence on both sides, I'm afraid, that people are trying to make the article speak with their own biases, and not working together to present ''the dialectic'' clearly.  There is far too much concern that our own biases be reflected in the article.  Anyway, enough of this--I think I've made my point (once again). --[[User:Larry Sanger|Larry Sanger]] 04:49, 21 October 2008 (UTC)
=== British House of Commons Science and Technology Committee report ===


:::Larry, I tried to express the homeopathic view sympathetically. Remember that table where I tried to get a translation of terminology? No cooperation.  
The committee commissioned by the British government has reassessed homeopathy as a treatment option under the national health service. It's enquiry sought written evidence and submissions from concerned parties (See [http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=408852&c=1 News in brief: Homeopathic assessment] and [http://www.parliament.uk/parliamentary_committees/science_technology/s_t_pn05_091020.cfm Evidence check: Homeopathy]). Both sides of the debate were represented and presented written evidence to the committee. In addition there were oral presentations from the following individuals:


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


:::There has been nothing to which a mainstream science response can be made. Mainstream medicine uses controlled experiments, measurable phenomena, peer review. This keeps coming back to anecdotes and "trust me". [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:59, 21 October 2008 (UTC)
A summary statement from the House of Commons Science and Technology Committee was released with the report in Feb 2010:
{{quote|... the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.


::::Au contraire.  What you ''just said'' is a mainstream medical response, it seems to me.
The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.  


::::As for that table to translate terminology, I would like to see it moved to [[Homeopathy/Catalogs]] and perfected. --[[User:Larry Sanger|Larry Sanger]] 13:47, 21 October 2008 (UTC)
The Committee concluded - given that the existing scientific literature showed no good evidence of efficacy - that further clinical trials of homeopathy could not be justified.


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


Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS. <br/>'''Source:''' UK Parliamentary Committee Science and Technology Committee - [http://www.parliament.uk/parliamentary_committees/science_technology/s_t_homeopathy_inquiry.cfm "Evidence Check 2: Homeopathy"]}}


== Statistic given in article does not appear in cited source ==
From the full report the committee also stated:
{{quote|
We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals — hospitals that specialise in the administration of placebos — should not continue, and NHS doctors should not refer patients to homeopaths.<br/>'''Source:''' [http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf Evidence Check 2: Homeopathy, Fourth Report of Session 2009–10], House of Commons Science and Technology Committee, 20 October 2009, parliament.uk}}


I have deleted this bit:
In conclusion the chairman of the committee said:
{{quote|
This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government's policies on homeopathy are evidence based on current evidence. They are not.


:42% of [[medicine in the U.K.|British doctors]] refer patients to homeopaths.<ref name="Fisher"/>
It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is 'evidence' enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government's response to our report with interest.<br/>'''Source:''' UK Parliamentary Committee Science and Technology Committee - [http://www.parliament.uk/parliamentary_committees/science_technology/s_t_homeopathy_inquiry.cfm "Evidence Check 2: Homeopathy"]}}


The article says that 42% of British doctors "refer patients to homeopaths."  I found no such claim in [http://www.bmj.com/cgi/content/full/309/6947/107 this article,] which was cited. All that I could find on a scan of the article was "up to 37% of British general practitioners use homoeopathy." There was also this: "Those who use homoeopathy regularly do so in about a quarter of their consultations, the proportion being higher for hospital and private specialists." A text search for the string "42" did not bring up the statistic.
: The Evidence Check definitely needs to be in the article. It has been hilarious watching the homeopaths squirming around trying to explain it away by butchering the quote from Cucherat's systematic review. It is like those reviews you see on movie posters where it says something like "Tremendous, Exciting (Evening Standard)" and then you go and look and see what the Evening Standard actually say and it is "A tremendous waste of time and money, has difficulty exciting all but the clinically insane". –[[User:Tom Morris|Tom Morris]] 15:12, 3 March 2010 (UTC)


Our article should note that ''this source'' is a review article and not reportage of original research findings.  For that reason it is difficult to tell exactly what the statistics mean, without looking up the article's sources. Does the 37%, or 42% (???), represent the number of British doctors who ''regularly'' refer patients to homeopaths?  Who have ever even once used it themselves, i.e., tried it out?  Who use it personally (i.e., not to treat their patients but themselves)?  Who use experimental therapies on their patients, that also happen to be used by homeopaths?  What?  I am sure that 37%/42% does not represent the number that ''regularly use'' homeopathy, for the simple reason that the article does also say that "those who use homeopathy regularly do so in about a quarter of their consultations," which seems to imply that there are those who use homeopathy, but not regularly.
:: For some reason, I couldn't access Citizendium yesterday at this time. Meanwhile, I got a reply from Dr Peter Fisher to my e-mail in which he says that the individual specific rules of Homeopathy were not followed in prescribing/administering the Homeopathic remedy, so I hope good sense prevails over the 'UK Parliamentary Committee Science and Technology Committee'.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:43, 12 March 2010 (UTC)


The statistic may also not be significant (and this should be stated in the article perhaps after a little discussion) due to the ''nature'' of the referrals, i.e., it is entirely possible that people are referred to homeopaths ''because patients specifically ask for such referrals,'' not because the physician would make such referrals generally.  Moreover, it would be important to know to what extent these physicians refer to homeopaths as a "last resort," after conventional medical solutions are tried, and patient and doctor are desperate to try things even if they may have no effect at all.
:::With regard to "the individual specific rules of Homeopathy were not followed in prescribing/administering the Homeopathic remedy" what is Peter Fisher referring to? How does that impact the report? [[User:Chris Day|Chris Day]] 16:25, 12 March 2010 (UTC)


I dwell on this point only to underscore a point that I believe Howard, Chris, and others are making here: these sorts of statistics ''absolutely do not'' speak for themselves. If you want to make such claims in the article, they have to be either properly clarified, or else qualified, i.e., mentioning the uncertainty about how they are to be interpreted.  ''Even if'' we have a neutrality policy, the license that the policy gives us all, to state our views forthrightly, ''does not also'' license us to make claims that are unsupported by the evidence (as the 42% statistic ''appears'' to be) or to make claims that are very vague and, due to their vagueness, misleading as to the evidence.
::::As I understand it, the individual specific rules of homeopathy mean that every patient is unique and the remedies appropriate for one will not be appropriate for another. Let's assume this is exactly correct. That would make classic randomized clinical trials, in which there is a standard treatment arm and a control arm, inappropriate, because there is no homeopathic standard.


I believe that all these claims should be checked ''and removed'' if similar problems to the 42% problem are found.
::::A very similar problem, however, applies to highly individualized [[pharmacogenomics|pharmacogenomic]] therapies: within a cohort of patients with, say, metastatic breast adenocarcinoma, the experimental hypothesis may be that a given treatment is applicable only to those patients with a specific BRCA gene coding. Panaceamycin is only expected to be effective in patients with that characteristic, and the others should get an aromatase inhibitor, the standard of care. Given there is a treatment, a placebo control is ethically unacceptable.  


Also, to the person who added the 42% statistic--may we please have an explanation?
::::RCT's have been designed that still have statistical power, but are testing the diagnostic and treatment model, not panaceamycin.  The clinician selects the treatment and sends an order to the pharmacy, where the pharmacist opens the next blind assignment envelope. If the patient is assigned to the experimental arm, the IV drug unit sent back to the care unit has panaceamycin in it if the genomic model calls for it, and the control treatment if not. If the patient is assigned to control, she gets control. It is the decision to assign that is being tested, more than the drug itself.


Finally, as to the point that such statistics are trying to make--that homeopathy enjoys the status and honor of ''intellectual support'' from medical doctors in these percentages--well, that doesn't follow from the statistics cited.  Someone might refer, or use, homeopathy, and do so being entirely skeptical of it--almost, as it were, superstitiously.  Human beings are like that. And on ''that'' point surely surveys have been done, and I'd like to see the results.  When asked directly, "Do you believe that homeopathy and its remedies are (1) always, (2) usually, (3) sometimes, (4) rarely, (5) almost never, or (6) never more effective than placebo?" what do they say (in different countries)? --[[User:Larry Sanger|Larry Sanger]] 14:32, 21 October 2008 (UTC)
::::In like manner, homeopaths could prescribe a totally individualized remedy, but they would be blinded to whether or not the patient gets the remedy -- control could be placebo, or a medical treatment. With a sufficiently large sample, if the homeopathic model is correct, the patients receiving the remedy should do better.


:Slow down, Larry.  The exact source of the reference for 42% of British physicians referring patients to homeopaths is:  R. Wharton and G. Lewith, Complementary Medicine and the General Practitioner, BMJ, 292, June 7, 1986: 1498-1500.  http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=3087494
::::It is not clear that homeopaths are willing to be tested in such a manner, which should obviate the argument about individualization not being permitted. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:05, 12 March 2010 (UTC)


:Actually, simply referring a patient to a homeopath is relevant for several reasons.  First, the doctor takes on liability issues in doing so, and therefore, s/he doesn't refer unless there is some type of respect or trust that the doctor has in the homeopath or the homeopathic method.  In either case, this IS relevant. It may be of additional interest to discover how often a doctor provides a referral, and such present or future surveys that deal with this issue can be added here, but I see no reason that surveys published in high impact journals should be ignored.  [[User:Dana Ullman|Dana Ullman]] 17:03, 21 October 2008 (UTC)
:::::Brings me back to a question that I have never seen an answer to.  How can remedies be mass marketed and sold off the shelf at places like wal-mart and whole foods and be so effective (as claimed)? These remedies are either robust or need to be highly individualized.  If the latter, I don't see how how a mass market product will work.  If the former, then they have indeed being found wanting (no better than placebo). Their defense against accepting the failed results of clinical trials precludes claiming successes from the mass market products.  Which is it? [[User:Chris Day|Chris Day]] 19:15, 12 March 2010 (UTC)


::Dana, as I said, ''the source cited by the article,'' marked as Fisher, ''did not contain the statistic.'' If you can support the statistic with a ''different'' source, that's great, but it does not address my point, which was serious. I'm afraid I'll have to ask again: ''who'' put the statistic, with that citation, into the article? I ask because I want an explanation of the error from that person. Was it perhaps an innocent typo, somehow?
::::::A question, Chris, that I've asked myself. Let me respond indirectly.  One of the major mass-marketed products is [[Oscillococcinum]], about which I did write an article. What is the sound that is made by the creature from which the simillium is obtained? --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:28, 12 March 2010 (UTC)


::It seems we can say that in this 1986 survey of 145 mail-in questionnaire respondents, who were Avon, England GPs, 42% had referred at least one patient to a homeopathic doctor or non-medical practitioner. --[[User:Larry Sanger|Larry Sanger]] 02:56, 22 October 2008 (UTC)
:::::::Given that they are a £1.5bn industry we can expect to hear a lot of noise like that in the next few months. [[User:Chris Day|Chris Day]] 19:40, 12 March 2010 (UTC)


===Questioning the answer of 42===
:::::::: Howard, you got it right - for example, Ipecacuanha can't be given where Antim. Tart is indicated. Chris, classical homeopaths don't accept 'over the counter'/'off the shelf' products because anything between 2 to 20 remedies are mixed in one 'combination' (Hahnemann used to call such homeopaths the 'mongrel sect'), but since it's popular, the classical homeopaths can't do much about it. In India, homeopathy is a half a Billion $ 'industry' - and that is only counting the medicines sold 'over the counter' and not what is spent on homeopathic doctors - so we're not gonna let people talk rubbish about it. It really works (See the 'feg' pdf document I've posted in the previous section)!—[[User:Ramanand Jhingade|Ramanand Jhingade]] 09:22, 13 March 2010 (UTC)
Doesn't anyone read Douglas Adams?


While I'd have to look for current data, entirely too many antibiotics are prescribed by mainstream physicians, often to meet the expectations of a patient or parent, but knowing full well that an antibiotic will do nothing for a self-limiting viral infection. They have, however, exposed their patients to toxicity, and the population as a whole to a source of drug-resistant bacteria. My point is that this is not a matter of pride to the medical profession, but something it is trying to fix.
Ramanand, you didn't get right the essence of what I was saying: there are statistically powerful testing methods, which have been developed for biological therapies that indeed are individualized, which could answer the homeopathic objection to more traditional randomized clinical trials. I have not seen any evidence that homeopaths are willing to use such methods, but instead continue to insist on either statistically weak retrospective analyses or anecdotal/testimonial evidence. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:21, 13 March 2010 (UTC)


Something worth knowing: how does homeopathy keep reinventing itself and improving its process? Does it?
:Howard, it is very simple: the homeopaths are perfectly happy to use clinical evidence when it shows that homeopathy works. But when it shows that it doesn't work, then the clinical trial methodology must be at fault! Heads I win, tails you lose. If clinical trials are unable to detect the effects of homeopathy, why is the British Homeopathic Association quote-mining Cucherat? What seems more likely: that homeopathy works but not to the point where the clinical trial can detect it, or homeopaths cynically misuse evidence to support their pre-ordained conclusions? It has been so amusing to watch: our politicians have seen that the <s>King</s> alternative therapist is actually nude. All the homeopaths have been able to do is spin, quote-mine and clutch at straws. –[[User:Tom Morris|Tom Morris]] 18:38, 13 March 2010 (UTC)


What are the shared, not the oppositional, concepts? There has been at least one individual, [[Harold Griffith]], fully trained in conventional and homeopathic methods, who received the Nobel Prize in Medicine or Physiology for contributions to surgical anesthesia. When does such a person not insist that homeopathic methods are the best for everything? Sorry, I'm extremely tired of asking and asking about when homeopaths refer, or use medical techniques in which they are trained, and be told "it depends". There are too many consensus guidelines, such as back pain, giving strategies for synergy, to accept that there can be no communication.
::I suppose there isn't really anything to do about it until there's a new Editorial Council and a reevaluation of workgroups. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:04, 13 March 2010 (UTC)


Constant repetition about popularity, about how much mainstream medicine is out to get the homeopaths, and how dangerous mainstream medicine may be is not effective communication. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:10, 21 October 2008 (UTC)
:::The draft is open to rewrite and, while I can't speak for everyone, I'll be glad to look at anything that gets put in it. I agree with Russell. [[User:D. Matt Innis|D. Matt Innis]] 03:17, 14 March 2010 (UTC)


:Howard, please note that homeopaths seem to honor the Hippocratic tradition with great rigor and vigor than conventional doctors do ("First, do no harm."). Homeopaths prefer to try and sometimes exhaust safer methods before resorting to the "bigger guns" (and more risky therapeutic measures). That said, each situation requires its own guidelines based on the medical urgency, the degree of known efficacy of the conventional medical treatment, and the initial response to homeopathic treatment. 
::::Howard, there is a lot of research going on in Homeopathy. Dr.Peter Fisher heads a research group in London and Dr.Rastogi heads a research group in India. I will email them about your suggestion. Tom, please look at the 'feg' .pdf document I posted - it is good, solid evidence that Homeopathy works!—[[User:Ramanand Jhingade|Ramanand Jhingade]] 11:44, 14 March 2010 (UTC)


:Charles Frederick Menninger (1862-1955), the founder of the famed Menninger Clinic, was the head of his local (Topeka, Kansas) homeopathic society.  He asserted, "It is imperatie that we EXHAUST the homeoapthic healing art before resorting to any other mode of treatment if we wish to accomplish the greatest success possible." (1897)...quoted on page 124 of my book, "The Homeopathic Revolution" (I can provide the original reference if desired).  [[User:Dana Ullman|Dana Ullman]] 00:22, 22 October 2008 (UTC)
Friends...in due respect, anyone who takes this "report" seriously has an axe to grind or is simply under-informed.   


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


::Charles Menninger was a great psychiatrist, who died around the time the first effective drugs for mental illness were being introduced (i.e., [[chlorpromazine]]) in 1952. Have you some equivalent works of homeopathy from prestigious psychiatrists in current practice, equipped with a bit more understanding of brain chemistry? While I think Menninger was a distinguished physician for his time, and set standards for ethical practice, the main therapeutic technique he introduced, and is still found valuable, is art therapy.  Were he to be reincarnated, I'd greet him with joy, and then suggest he take a year or two of current clinical science, and probably two years or so of supervised fellowship, before I'd want him to treat anyone whom I cared about.  Bluntly, I don't much care what he had to say about homeopathy, because he was unaware of sixty years' better understanding of neuroscience, cognition and psychopharmacology &mdash and I am not referring to drugs alone. [[Cognitive behavioral therapy]] and other methods also have replaced many of the psychodynamic methods he used. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:44, 22 October 2008 (UTC)
The very limited number of people who represented homeopathy were primarily three people.  The others were entirely antagonistic to homeopathy or simply uninformed about it (such as the rep from Boots).   


:::Er...guys?  This doesn't have anything to do with the article.  It seems to be a pointless debate, unless a particular part of the text rests on its outcome, which I doubt... --[[User:Larry Sanger|Larry Sanger]] 03:00, 22 October 2008 (UTC)
Despite the use and acceptance of homeopathy throughout the U.K., there is a very active group of skeptics, with significant Big Pharma funding, who work vigorously to attack this system of natural medicine. Even though there is a wide variety of serious and significant pressing issues in British medicine and science today, an active group of skeptics of homeopathy successfully resurrected in October, 2009, a House of Commons committee, called the Science and Technology Committee, with the intent to issue a report on homeopathy. A leading skeptics organization, Sense about Science, that has been pushing for the re-creation of this Committee is led by a former public relations professional who worked for a PR company that represents many Big Pharma companies. Of additional interest is the fact that other Directors of the Sense about Science organization are a mixture of former or present libertarians, Marxists, and Trotskyists who also, strangely enough, seem to advocate for the GMO industry (ironically, libertarians normally advocate for a "live and let live" philosophy, but in this instance, it seems that they prefer to take choice in medical treatment away from British consumers).


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


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


At Larry's suggestion, I created the subpage "Homeopathy > Catalog" at http://en.citizendium.org/wiki/Homeopathy/Catalog (how '''do''' you wikilink to a subpage?). It is intended to compare and contrast terminology used in homeopathy and mainstream medicine. It has a basic assumption that, in certain cases, there are either terms of art, or words that are used differently.
A report from this kangaroo court was issued recommending that the National Health Service stop funding for homeopathy and homeopathic doctors, despite the support for homeopathy and for consumer choice from Mike O'Brien, the country's present Health Minister. This report is only of an advisory nature, and because the Health Minister has already expressed his support for consumers' right to choose their own health care, it is uncertain what, if anything, will result of this report. What was most surprising about this report was that it verified that when people repeat a lie frequently enough, such as "there is no research on homeopathy," many people actually believe it, despite its transparent falsity.[[User:Dana Ullman|Dana Ullman]] 05:33, 7 May 2010 (UTC)


If mutually agreed words can be found for the same concept, that would be a pleasant surprise. What I do hope to accomplish is, effectively, a dictionary between different systems. Some terms may not translate or be rejected by one side or the other; making that clear would be useful.
== Sources ==


[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:23, 21 October 2008 (UTC)
I'm surprised that this article does not reference or discuss Paul Starr's Pulitzer Prize and the Bancroft Prize winning book on the social transformation of American medicine.  Any article that wishes to understand the difference between allopathy and homeopathy needs to understand that this debate has less to do with science or medicine and everything to do with politics as the British report makes clear.  [[User:Russell D. Jones|Russell D. Jones]] 15:41, 2 March 2010 (UTC)


[[Homeopathy/Catalogs]] --[[User:Larry Sanger|Larry Sanger]] 03:03, 22 October 2008 (UTC)
:At one time, it was indeed appropriate to compare allopathy and homeopathy.  While some dictionary definitions still use allopathy as a synonym for conventional medicine, I find the modern usage to be more often by CAM practitioners, as that-which-we-do-not-do. (For the record, I happen to find some ''complementary'' medicine useful, or at least worthy of trial in non-critical situations.)


== Statistical methods for testing highly individualized therapies ==
:As far as a "modern" comparison, however, I cannot do better than William Osler:
It's probably easier to create some notes again than find the previous postings in the archives. Gareth had some very eloquent things to say on the topics.
:<blockquote>A new school of practitioners has arisen which cares nothing for homeopathy and still less for so-called allopathy. It seeks to study, rationally and scientifically, the action of drugs, old and new."(Flexner report, page 162)</blockquote>


There are emerging areas of medicine where the traditional [[randomized controlled trial]] has methodological problems. Among them is [[pharmacogenomics]], in which therapy is individualized not only based on the medical history, physical examination, and routine laboratory and imaging studies, but also on genetic analysis and specialized laboratory tests suggested by such analysis. Among a group of patients with similar symptoms, it may be found that a specific bad protein is causing damage, but the reason for the protein being damaged could be controlled by a number of different genes, each responsible for an intermediate step in the synthesis of the final protein.
:Unquestionably, there was once a competition between something one could legitimately call allopathy, as a "doctrine of opposites", and homeopathy as a "doctrine of similars". Homeopaths often selectively quote Osler as saying that the homeopathic remedies were safer than most allopathic remedies of his era (i.e., late 19th-early 20th century). You'll note that there was insistence on keeping the 1905 quote from von Behring.


Approved immune-based treatments, such as monoclonal antibodies to [[tumor necrosis factor-alpha]] in rheumatoid arthritis, reduce the level of the final protein. By concentrating on that final protein, a large enough group can be collected for a conventional clinical trial.
:It ain't the 20th century any more, and conventional physicians don't prescribe based on opposites, nohow. Yes, there are political residues, but there's now a lot more in the way of evidence-based medicine...and protecting turf. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:37, 12 March 2010 (UTC)


Increasingly, however, we are aware that the protein synthesis error could happen at an intermediate step, controlled by one of a long list of genes. The least invasive and most effective treatment may be to administer a neutralizing agent that only affects the step where some protein is not created correctly, as defined by genes.
::My favorite quote from Paul Starr's book is:  “Because homeopathy was simultaneously philosophical and experimental, it seemed to many people to be more rather than less scientific than orthodox medicine.” [[User:Dana Ullman|Dana Ullman]] 05:37, 7 May 2010 (UTC)


At present, the trial approach being considered is to have a clinical team examine the patient, and prescribe what they consider to be the appropriate treatment. That prescription goes to the pharmacy, where the pharmacist opens the next sealed envelope, which says if this patient is to be assigned to the control group or to the experimental group. If the patient is assigned to experimental, then the exact prescription, individualized to that patient, is made up; otherwise, it will be a control treatment or placebo.
== The memory of sugar ==


At the end of the trial, measurable outcomes of success &mdash; not subjective measures such as "satisfaction" &mdash; are compared between the experimental and control groups. Every patient in the experimental group may have received a different, personalized modified monoclonal antibody. If there are better outcomes in the experimental group, the trial confirms the '''methodology''' of selecting treatments rather than the treatment proper.  
is being discussed [http://ff.im/gOS59 here] and provides a nice illustration of the topic. --[[User:Daniel Mietchen|Daniel Mietchen]] 21:56, 3 March 2010 (UTC)


Such an approach, it would seem, could be applied to homeopathy. Has it? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:23, 21 October 2008 (UTC)
:I thought the "memory of sugar" tended to go either to the abdomen or buttocks, depending on genetics? :-)


== Specific immune benefits of chickenpox and measles? ==
:Seriously, the discussion at that link is what I'd suggest is an expectation. It is possible to be neutral, I think, and mention, in the lede, that homeopathy is not generally accepted. We still do not have a way of dealing with the situation where homeopathy supporters will support a lede that doesn't consider it reasonably credible. Of course, in no other workgroup do we have an equivalent to the health sciences/healing art splits. Should Religion be joined by Atheism?  Alternatively, is it possible to have a reasonable Atheism article in Religion? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:46, 3 March 2010 (UTC)


There is a reference to Randall Neustaedter's ''The Vaccine Guide'' which is cited for a homeopathic belief that there are immunological benefits from contracting measles and chickenpox, rather than immunizing against them. Could someone, with access to this book, describe these benefits?
::The problem just isn't there with religion and atheism. If you, say, are interested in philosophy of religion, you can get a degree in it regardless of whether you are an atheist or a theist (or something else entirely). I say this from experience - I have a BA in Philosophy, Religion and Ethics from a Catholic college but am an atheist. There are some - I guess the polite way of saying it is 'non-mainstream' - ways of getting a doctorate in religion. You could become a "Doctor of Scientology" (D.Scn) - I read today that Ron DeWolf - Hubbard's son - had been given one, and stated in court that he wasn't sure whether they gave him the Doctorate before or after he'd been given the Bachelors! Or you could get a phony Ph.D from a diploma mill - as quite a lot of the creationists have. The problem with Healing Arts is that you can quite feasibly become a Healing Arts editor with a degree from a non-mainstream parallel academic institution. When mainstream academia isn't bending over backwards to certify degrees in quackery (as two universities in Britain shamefully have), the quacks create their own academic institutions.


Have the benefits of chickenpox been weighed against the future risk of [[herpes zoster]]? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:19, 21 October 2008 (UTC)
::"Dr" Gillian McKeith "PhD" has a degree from a place called Clayton College of Natural Health in Birmingham, Alabama. Said college is not accredited by any accrediting body recognized by the Department of Education, and a number of states in the U.S. list it as unaccredited on their websites for student loans (etc.). This does not stop McKeith claiming to have a PhD on her website, nor did it stop Channel 4 television or her publisher from touting this to promote her books and TV programme. She also likes to mention how she is a member of the American Association of Nutritional Consultants. You too can be a member of the American Association of Nutritional Consultants if you send them $60! McKeith has pushed notorious nonsense like the idea that green vegetables are good for you because the green shows they have chlorophyll (true), and the chlorophyll will oxidate your blood (how? Human beings are not plants. They tend to get their oxygen through respiration rather than photosynthesis. And even if they were getting their oxygen through photosynthesis, even your local tanning salon lamps aren't quite powerful enough to penetrate your small intestines).


: Howard, this subject doesn't have a place on THIS article.  I have, however, read studies that show that people who experience measles have a statistically significant reduced rate of atopic disorders.  Although one might conclude that measles provides some type of immunological benefit here, another interpretation could be that the measles vaccination increases atopic states. There is a body of literature on the "hygiene hypothesis."  [[User:Dana Ullman|Dana Ullman]] 00:29, 22 October 2008 (UTC)
::Another graduate of the Clayton College of Natural Health is cancer quack Hulda Clark who sells a whole variety of magic 'zapping' toys that make funny noises and shine lights and do little more to cure cancer than extract money from punters - I mean, cancer sufferers.


::Are you ignoring the first paragraph and answering the second? If you are answering the second, fine. Your call. I might point it out myself.
::Take any philosopher of religion or even most theologians - they'll certainly be able to say something useful on an article about atheism in the Religion WG. Same for the non-believers within the same fields. The problem with Healing Arts is it lets people with completely bonkers views about reality approve articles on their favourite pseudoscience. If the claims of the homeopaths were true (and, blimey, even our politicians can tell what a big pile of nothing the evidence of two hundred years of homeopathy has amounted to), then most of the articles in the Biology and Chemistry workgroup need rewriting.


::As far as the first point, are you saying the inadequately sourced claim about advantages of measles and chickenpox should go? If so, I agree. This is an encyclopedia: if controversial things are said, they need verifiable sourcing. They indeed may be controversial and stay, but there should be readily available information from credible sources.
::I'll repeat myself again: we need to fix the Healing Arts bug. It is nothing more than a bug. It is a bug that is bringing down the great work done by other WGs. It says to anyone who has spent years of their life working on getting a PhD in physics or literature or psychology or whatever that you can get a fake degree from a non-accredited university and also be considered an expert on the same level. How can I, in good conscience, tell the experts in my field to contribute given this significant vulnerability in the Editorship system? –[[User:Tom Morris|Tom Morris]] 01:21, 4 March 2010 (UTC)


::Or did you want to talk about atopy, the Prausnitz-Küstner reaction, and better ''in vitro'' alternatives? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:51, 22 October 2008 (UTC)
:::Religion seemed the obvious parallel, but we could, I suppose, have an Absolute Pacifism workgroup with Military -- not that quite a few professional soldiers don't hate war. Why can Engineering debunk a hoax theory but Health Sciences cannot? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:15, 4 March 2010 (UTC)


:::I substituted references to Neustaedter's online articles for the book. In those, I did not see any that specifically said there were benefits to measles and chickenpox, although he does argue strongly against all forms of immunization, with no scientific data.
::::Howard, you're one of the eight Charterists. Are you a loud and strong voice therein trying to *remove* Healing Arts as a Workgroup, so that some of this nonsense could then be addressed in the future in a rational way? [[User:Hayford Peirce|Hayford Peirce]] 02:49, 4 March 2010 (UTC)


:::The adult recurrence of [[chicken pox]], [[herpes zoster]], is a much more serious condition that can be prevented with childhood chicken pox immunization. I gave a citation to ''Mobidity and Mortality Monthly Report'' regarding the public health threat of herpes zoster, and the now universal recommendation of herpes zoster vaccine to adults of 60 years and older. Unfortunately, while the incidence of herpes zoster goes up significantly with age, it can also occur in immunosuppressed individuals. Herpes zoster affects 1 in 3 adults, and, in 10-25%, can result in permanent chronic pain, eye damage, or both. Chicken pox is a problem of public health not limited to childhood. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 20:11, 25 October 2008 (UTC)
:::::Compromise in the Charter Committee, I believe, means that the Workgroup and some other details will be passed, without detailed guidance, to the Editorial Council. Personally, I am urging the draft to go to discussion and markup, so we can proceed to the next steps after ratification. While this is an especially galling problem, there are less egregious workgroup structure problems that also need addressing and can't happen at the Charter level. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:21, 4 March 2010 (UTC)


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


Just to keep everyone informed, I have made several edits on the "Trials in humans" section, first trying to clarify the flow. While I'm still working on it, I tried to move the introductory text by a CZ contributor to the beginning of the section, and put the various trials under subsections below them. Of course, when there is CZ commentary on a particular trial or meta-analysis, the comment belongs in that subsection.
:::::No, the analogy may hold. There are those that will insist that any enemy can be defeated through passive resistance and good thoughts, just as some of the healing arts believe that it is utterly wrong to immunize against an infectious organism or use an antibiotic against one. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 07:43, 4 March 2010 (UTC)


Material on ''The Lancet'' controversy was especially hard to follow, because multiple references were all under the same footnote number. I broke them into separate footnotes, and added at least some material about what each author(s) actually said; it was otherwise very confusing.
::::::Tom mentions non-mainstream ways of getting doctorates in religion. In fact the Archbishop of Canterbury still has the legal power to award them, which might explain why Church of England bishops always seem to be Dr. [[User:Peter Jackson|Peter Jackson]] 14:29, 12 March 2010 (UTC)


With respect to the Cochrane meta-analysis of [[Oscillococcinum]] (I've started an article on this preparation), I found the actual conclusions of the free summary to be a bit different than the one word, "promising", that described the work.
==How well does it work?==


There was a section under "trials in humans" that was not about trials, pertaining to over-the-counter remedies. I moved it to be with other material on nonprescription remedies, and changed the section from "Popularity of Homeopathy" to a more comprehensive and neutral "Popular opinion and over-the-counter homeopathic remedies". "Popularity", like "Criticism", may not be the best of encyclopedic headings. "Public opinion" may be even more neutral than "Popular opinion".
We use double-blind studies to tell how well a particular medicine works. The person handout out the medicine does not know whether it's a "real medicine" just a sugar pill. In the case of pain relievers, the potency of an [[analgesic]] is rated in terms of how much more effective it is than a [[placebo]].


The last paragraph, under the "Lancet" subheading, appears to be text from a CZ contributor. In its first sentence, it contains a '''value judgment (my emphasis)''' that I believe needs to be sourced and explained: "Several of these published responses remarked '''(incorrectly)''' that the researchers evaluated only those studies that met certain criteria for “high quality” scientific investigations."
If I recall correctly, as much as 75% to 90% of the effective pain relief you get from the pills comes from the placebo effect: you take your aspirin or ibuprofen or (without knowing it) your sugar pill, and your headache starts going away within an hour no matter what. The real stuff is only slightly better.  


:: That text ('''(incorrectly)''') was mine. This criticism is repeated in several sources but is simply wrong. The authors used a hierarchical approach - they looked at the outcomes of all studies and then looked at the outcomes if only large high quality studies were considered. Their hypothesis was that if there are factors like publication bias that lead to the selective publication of studies with positive outcomes, then size of effect should be inversely related to sample size and study quality. So it's a common criticism but reflects a fundamental misunderstanding of the study. How would you phrase it? I didn't expand because the preceding text explained the study in terms that I thought made it clear that the reported remark was transparently incorrect. I didn't see it as a value judgement, simply a statement of demonstrable fact. [[User:Gareth Leng|Gareth Leng]] 15:57, 22 October 2008 (UTC)
Given all that, how would we design a study to compare homeopathic treatment with conventional treatment? Is it possible to conduct a blind study, if the way the healer deals with the patient is a key ingredient of the therapeutic effect?


:::Thanks. My first thought would be to take the explanation you just wrote, edit it slightly, and either put it as a subhead of [[randomized controlled trial]], or one of several very short articles (the sort I'm always arguing are too short to need definitions) on trial methodology. Thinking of some of my own edits in totally different areas, I've written articles that state the facts of a matter, and linked to them, making them reusable. Perhaps we need some sort of mini-article format that is variously a FAQ, or a "common error". I can definitely think of things in my computer science book, where I'd insert sidebars explaining that I knew the main text was counterintuitive, but there was a reason for it -- and then either a quick explanation or a citation.
For that matter, how can we compare Freudian [[psychoanalysis]] to Berne's [[transactional analysis]] or modern [[rational-emotive therapy]] or to a frank chat with a trusted friend or mentor (like Father O'Malley down at the local Catholic church)?


:::I know you have time constraints, but I find you more eloquent than I on describing study methodology. Thinking about it, there were two problems. First, I was sensitized to some cases where others were throwing in unsupported, sometimes angry comments. Second, I was not sure if the antecedent (referent?) of "incorrectly" was to interpreting publication bias, to the idea of the inverse relation you mention, or something else entirely. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:40, 22 October 2008 (UTC)
* I daresay one result of a careful attempt to measure outcomes could be that "bedside manner" is much more important than we've allowed ourselves to realize.  


I am continuing to follow the citations in the last two sections. Some appear to be evaluating patient satisfaction or subjective assessment as endpoints. While that is a perfectly legitimate thing to study, it should not be confused with the type of endpoint that is generally used in [[evidence-based medicine]].
But I ask again, how do we study and quantify it? --[[User:Ed Poor|Ed Poor]] 02:04, 28 March 2010 (UTC)


If I do find subjective endpoints, I propose to create a subsection under what may be renamed again, currently the "Popular opinion..." If formal studies of individual patient subjective response to treatment, as opposed to general opinions of homeopathy, were done, those are significant and need to stand apart from general opinion surveys. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:35, 22 October 2008 (UTC)
::If one were to review the entire body of experiments that Thomas Edison conducted on electricity, one would have to say that the vast majority of his experiments were failures...and one might fall into a trap by saying that he was a failure. Of course, we KNOW that this is not true. Just because some studies have shown that homeopathic medicines don't work, there is a greater body of research to show that it does.  The trick is to know WHEN homeopathic medicines work...and when they don't.


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


Going through some of the trials (see "Other Meta-analyses") that showed promise, but not necessarily statistical confidence, a number of the researchers suggested that perhaps the wrong things are being studies. There may be more to be learned from the quality of interaction between homeopath and patient than there is from deeper insight into the memory of water, or even some large-scale on homeopathic remedies for self-limiting conditions, or where there are generally acceptable treatments.
== Unsupported assertions ==


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


I did remove two items (below) that did not perform a meta-analysis:
This is obviously redundant; we need ''at most'' one of these statements. However, neither strikes me as believable without support, so I am inclined to delete both. Anyone care to comment before I edit? [[User:Sandy Harris|Sandy Harris]] 15:29, 26 June 2010 (UTC)


*A meta-review of homeopathy in [[dementia]] did not actually analyze any studies. The investigators were unable to find papers that met their inclusion criteria, and said they could not assess the extent of homeopathic treatment of dementia. <nowiki><ref>{{cite journal |author=McCarney RW ''et al.'' |title=Homeopathy for dementia |journal=Cochrane database of systematic reviews |pages=CD003803 |year=2003 |pmid=12535487|http://www.ncbi.nlm.nih.gov/pubmed/12535487 }}</ref></nowiki>
:Your point about unsupported assertions has come up before, and the current text, in my opinion, is significantly misleading. "homeopathy is practiced by many conventional physicians" does not, as much as some may want it to do so, imply that conventional positions endorse all of homeopathy. By definition, if they are conventional physicians, they are ''not'' practicing homeopathy as alternative medicine, but are using some complementary techniques from homeopathy. When I was last in my internist's office, I banged my shoulder against a piece of equipment. He rubbed it a bit. Does that mean he practices massage therapy?


*One reference was not from a journal, but a lay health encyclopedia produced by the National Health Service. <nowiki>:<ref>{{cite web|url=http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=197&sectionId=27 |contribution=Homeopathy results | title= Health encyclopaedia |accessdate=2007-07-25 |publisher=[[National Health Service]]}}</ref>.</nowiki> It could not be considered a meta-analysis, as it contained little quantitative information.
:"Patient satisfaction" is a purely subjective assessment and is in no way evidence of efficacy.  I could take the sentence starting "Some medical doctors..." and substitute "chemically pure water that has not been exposed to a simillium" and demonstrate high patient satisfaction.  


[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:10, 22 October 2008 (UTC)
:I agree with deleting both. Even if citations are offered, they must be of a quality that indicates that homeopathic methods are a significant part of the practice of these physicians and they are not using it with the intent of creating placebo effects. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:05, 26 June 2010 (UTC)


:Good sleuthing Howard. I'm sorry that I didn't catch these ones. [[User:Dana Ullman|Dana Ullman]] 02:43, 23 October 2008 (UTC)
:: It is a fact that at universities in Germany and Austria there are chairs and lectures on homeopathy (in Vienna also at the veterinary university). There are doctors who practice both. --[[User:Peter Schmitt|Peter Schmitt]] 23:10, 26 June 2010 (UTC)


==Text cut==
::: I have no problem if the two sentences ar combined. I think we've gone over this several times on the talk pages.  As Peter points out, there are obviously well established 'conventional' medical professionals that use homeopathy for treatment of medical conditions.  This is pretty much common knowledge at this point, so I don't see the need for citing a source for the mere fact that some medical physicians use homeopathy in their practices.  However, when we add specific numbers such as 30-40%, it does seem to beg for a reference.  It shouldn't be hard to find such a reference if it is out there. Otherwise, removing the numbers and just stating the fact shouldn't be a problem. 
I cut a few lines from the secton on regulation because they didn't seem to belong there, but in [[Memory of Water]], I've placed them pro tem on the Talk page of that article.[[User:Gareth Leng|Gareth Leng]] 13:18, 23 October 2008 (UTC)


:There remains an issue that deals with (diluents? vehicles?) other than water. The introduction says water or ethanol. Plausible ethanol solvents, especially if there are limits on over-the-counter concentrations as in the U.S., have enough water so memory of water, if it exists, could apply.
::: I don't think we will be able to find any scientific sources that conclude that they use it only on undereducated healthy people as a placebo. In fact, I think the opposite is more likely the case. [[User:D. Matt Innis|D. Matt Innis]] 01:22, 29 June 2010 (UTC)


:In the body of the article, however, remain references to lactose and quartz. These were taken out of the earlier introduction. Can we have a decision? If there are homeopathic diluents (yes, they ''are'' diluents as pure chemicals before mixing) other than water, let's be consistent between the lead and the body.
Would someone who has access care to correct the glaring English mistake in the first paragraph of this approved article? [[User:Ro Thorpe|Ro Thorpe]] 00:16, 2 July 2010 (UTC)


:Certainly, lactose is very common in mainstream pharmaceuticals, simply to bind small anounts of drug into a tablet large enough to handle. I don't find it implausible that it could be used in preparing a remedy, but that does suggest that memory of water isn't the mechanism.  Quartz seems a little more unlikely, but I suppose it's safe if sufficiently powdered; still, it's usually not the greatest idea to put insoluble substances into the gastrointestinal tract.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:28, 23 October 2008 (UTC)
:I'm sorry, Ro, I must have a blind spot that is preventing me from seeing this glaring error.  Could you be so kind as to point it out? [[User:D. Matt Innis|D. Matt Innis]] 01:42, 2 July 2010 (UTC)


::Don't know about quartzm, but it's obviously common to use lactose/sucrose in powder or tablet form. These dry forms contain no water, so I don't know what homeopaths think may be the mechanism in this case; I've added a few simple lines about this.[[User:Gareth Leng|Gareth Leng]] 15:53, 23 October 2008 (UTC)
::Oh, so go ahead and shoot me!  I found it (after reading your request for Hayford to repair it :) [[User:D. Matt Innis|D. Matt Innis]] 01:46, 2 July 2010 (UTC)


== Text reverts on 12 October...ongoing ==
:::Bang, bang - but you've removed it! Many thanks! [[User:Ro Thorpe|Ro Thorpe]] 12:16, 2 July 2010 (UTC)


:"<s>because homeopathic remedy selection may take time</s>; homeopathic remedies may be used after an asthmatic episode <s>to optimize the immune system and</s> prevent recurrences."
I provide many solid references to the use of homeopathic medicines by physicians in Europe in an article I wrote at:  http://www.huffingtonpost.com/dana-ullman/homeopathic-medicine-euro_b_402490.html  (It is NOT my intent for anyone to reference this article in OUR article at this website.  Instead, we can use many of the references provided.  This article also has many references throughout the article showing that people who use homeopathic medicines tend to have more education than those who don't.) 


Of course homeopathic remedy selection takes time; most non-emergency selection of medical drugs take time. Even in an acute asthmatic attack, it may take corticosteroids, even intravenously, 8 hours to have an appreciable effect. Saying it may take time to select long-term drugs simply adds words without adding information
I urge us to be very careful in significant changing this article because a lot of time and thought went into it previously. [[User:Dana Ullman|Dana Ullman]] 18:05, 14 July 2010 (UTC)


As far as "optimize the immune system", that has no meaning in the general scientific usage of "immune system". Why is it wrong to remove those words and leave "prevent recurrences", which is presumably the objective?
== Review by a sceptical layman (i.e. me) ==


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


''Please'' don't take well-defined medical terms and give them new meanings, or use oversimplifications. Doing so breaks down any hope of communication between conventional and homeopathic participants here. Truly, I would not object if you had said "vital force" rather than "immune system". I don't know what a vital force is and whether it exists, but I am quite willing to accept that it is meaningful to homeopaths, and saying a remedy increases it does not conflict with medical terminology. Without insisting on a definition of vital force, if it were substituted for immune system in several places, I think the article would be more readable for all disciplines. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:17, 12 October 2008 (UTC)
* I rewrote the paragraph in the lede section about the "long safety record". The reason homeopathy has a long safety record is the very same reason that not travelling has a long safety record: if something is inert and chemically indistinguishable from the delivery mechanism, it will be safe. Safety and efficacy is a balancing act. The reason homeopathy is safe is precisely because it isn't efficacious.


* I'm not wild about long, windy footnotes about Romanization. I've thus split off the Romanization note about the word "[[qi]]" on to a separate page.


Quite a few reverts later.  The inclusion of "''[http://en.citizendium.org/wiki?title=Homeopathy&diff=100397421&oldid=100397413 because homeopathic remedy selection may take time]''" has been removed by Howard, Gareth and myself. An explanaition for why this is a critical sentence other than "this is how I treat myself" would be useful to move us forward. [[User:Chris Day|Chris Day]] 14:03, 15 October 2008 (UTC)
* The section that is disputed about the number of practitioners in France and Germany is ''in the wrong place''. The way in which homeopathy is prescribed or accessed doesn't seem to be to be a principle of homeopathy - homeopathy is homepathy whether it is prescribed by a homeopath or bought over the counter. I've thus moved it into the section which used to be titled "Professional homeopaths: who are they?" which I have retitled "Homeopathy in practice". This section seems to be the place to discuss provision, prescription, education, regulation and the like.


:[http://en.citizendium.org/wiki?title=Homeopathy&diff=next&oldid=100398606 Just got reverted again], is "''I use it in acute attacks also-most homeopaths do; justify deletion (if you do) on the Talk Page ''" a convincing explanation? One that convinces Gareth and Howard? Is CZ comfortable "''[http://en.citizendium.org/wiki?title=Homeopathy&diff=100396567&oldid=100396566 messing with anaphylactic shock]''"? I thought Gareth made a reasonable point, not to mention the addition [http://en.citizendium.org/wiki?title=Homeopathy&diff=100396837&oldid=100396835 seems redundant with the sentence that follows]. Ramanand seems to imply that remedy selection does not take much time since he seems to be describing the use of homeopathy to control anaphylactic shock/acute attacks of ashma. I saw that Ramanand reduced the typical time for consultation with a homeopath from [http://en.citizendium.org/wiki?title=Homeopathy&diff=100398615&oldid=100398612 one hour to fifteen minutes], I assume with this scenario of "''acute attacks''" in mind (since it was the edit right after his revert). How do we know this is not an exaggeration or is there no consultation with "acute attacks" (even 15 minutes sounds on the long side here)? And if this remedy for "acute attacks" works so well, have any trials been done to prove to the skeptics that homeopathy is effective, at least for this type of case? This remedy would seem to be a perfect candidate for a double blind trial since individualisation appears not to be required in these cases and alleviation of the attacks should be easy to quantify. [[User:Chris Day|Chris Day]] 04:14, 16 October 2008 (UTC)
* The paragraph starting "Homeopathic remedies can be prescribed by professional homeopaths" seems to be a tricky one. Depending on the country and the regulatory regime, homeopathy can be prescribed by a wide variety of people. Sadly (in my opinion), in Britain, quacks of all sorts can have their merry way with the public. Pretty much anyone can set themselves up as an alternative practitioner, so long as they don't make their claims too specific. But in other countries, this varies. It seems the important distinction that needs to be made is that homeopathy - unlike, for want of a better description, ''real'' medicine - can be prescribed by anyone.


::Part of the problem is that the severity of the attack is not clear. Is it, as you suggest, anaphylactic shock? Status asthmaticus?  Things where it's a minute-by-minute call on whether to intubate, because laryngeal edema is one possibility? Do you have a rapid sequence intubation kit open and ready? Are arterial blood gases available? Even for a relatively mild but urgent case, that patient needs pulse oximetry, O<sub>2</sub> by nasal cannula and by more intrusive means if the SpO<sub>2</sub> drops. Nebulized albuterol,probably with intermittent ipratropium bromide, is almost certainly appropriate, while establishing IV access for epinephrine (unless it's intratracheal). Again assuming a serious event, a loading dose of methylpredisolone should be going on board. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:34, 16 October 2008 (UTC)
* The rest of the section on "A typical homeopathic visit" seems to have some glaring problems. The homeopath is supposed to have EMT training in order to be "adequately trained"? (Heh. Surely, if heart attacks are the problem, what you need to do is to dilute high-fructose corn syrup into non-existence and it'll clear right up? I thought they believed in the law of similars. What's a defibrilator doing in the homeopath's office?) But anyway, this adequate training is according to ''who''? According to government regulations? According to the homeopathic groups? According to us? According to some third-party regulator like the [http://www.cnhc.org.uk/pages/index.cfm CNHC]?


:::Gareth was the one that brought up anaphylactic shock, ramanand uses the phrase acute attacks.  You tell me if they are the same? Either way, if homeopathic remedies can alleviate acute attacks in minutes, I'm impressed. That's definitely quantifiable and publishable. [[User:Chris Day|Chris Day]] 04:42, 16 October 2008 (UTC)
* The article describes "classical homeopathy" at length, but I haven't seen any discussion of what the alternatives are to classical.


::::I've been verifying this with a reasonably current Lange emergency medicine text, and, while there are similarities between anaphylactic shock and the most severe form of exacerbation of asthma, there are differences.
* There is a lot of repetition of parts of the article. The 'Principles' section is repeated in the section on 'The claims for homeopathy'.


::::In both, you want tight monitoring of the airway, but laryngeal edema is far more a threat in anaphylactic shock than status asthmaticus. The tendency to secure the airway by intubation is greater in anaphylaxis, because with sufficient edema, you may not be able to intubate -- you may have to do cricothryotomy or something more invasive. Epinephrine is the first-line drug for analphylaxis, with antihistamines (H<sub>1</sub> and H<sub>2</sub> both). and beta-adrenergic agonists as backup drugs; in severe asthma, beta-adrenergic agonists are the first-line, supplemented with anticholinergics. Both call for parenteral corticosteroids, but those take hours to take effect.
* No criticism seems to be made of the "treating the whole person" idea. I'm not even sure that this is a desirable thing. If I break my arm, I want my arm fixed, not someone to waffle about my "disturbance in the overall homeostasis of the overall being". In fact, when I broke my arm as a child, I'm very glad that I had access to a surgeon to fix it. This kind of rhetoric seems to be just an evasion tactic - if the studies don't show that homeopathy actually fixes anything (and, well, it wasn't going to put the bones in my elbow back together), then they can justify this kind of thing by pointing out that the person feels vaguely better in some holistic sense.


::::On occasion, my ex-wife managed both. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:56, 16 October 2008 (UTC)
* The paragraph about corticosteroids seems to be totally out of place. Oh, it sort of makes sense - it is a follow on from the last paragraph about homeopathy and asthma.


::::There is some, 'individualization' involved even in acute attacks (of Bronchitis) - & no, I'm not talking of anaphylactic shocks. I did mention some remedies earlier (like Ars.Alb., Nat.Sulph & Ipecac), but it's difficult to explain all that to non-homeopaths, so I haven't included it in the article.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:11, 17 October 2008 (UTC)
I've got a more radical suggestion. This article obviously needs a fairly ground-up rewrite. Here's what I reckon we should do. The current article seems to have been put together in a rather piecemeal way. Instead, I think the best way is to see if we can come together and work out a list of the fundamental questions that a good article on homeopathy should answer - then build a simple structure around those questions, and fill them in. We may be able to repurpose some of the text from the existing article.


:::::Why is it so difficult to explain? I can give a mechanism of action for most pharmacologic drugs, or at least a reasonable approach to one? Perhaps the homeopathic model that there are no causes and effects are making it hard to explain. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:56, 16 October 2008 (UTC)
I'd suggest the following list of questions:


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


:::::In any event, if it cannot be explained, and can only be taken on faith, it belongs in a CZ article in much the form "Creationists believe that all forms were created by the deity and there has never been evolution." Try that. "Remedies", as opposed to non-homeopathic-lingo "symptoms", do not explain anything.
Before formulating a structure for any potential rewrite, I'm interested in seeing if anyone has any other questions that they'd want to add. –[[User:Tom Morris|Tom Morris]] 12:30, 4 July 2010 (UTC)


::::::Please do not tell me I'd understand if I tried it -- oh, and I happen to consider "skeptic" a compliment, so if you are trying to intimidate me with that, it's a waste of time. [[User:Howard C. Berkowitz|Howard C. Berkowitz]]04:37, 17 October 2008 (UTC)
:Tom, I only have a few minutes right now, but  let me share a thought or two. My greatest unanswered question is "what is the cognitive process of a homeopath in a patient interaction?" In other words, homeopaths say that every remedy is individualized. Whenever I posed this question to Dana, it was brushed aside, saying that one had to be a trained homeopath to understand.


Latest iteration.  Gareth removed it again with the following edit summary: "''[http://en.citizendium.org/wiki?title=Homeopathy&curid=100005146&diff=100400523&oldid=100400522 don't imply homeopathy is a substitute for necessary medical treatment]''". [[User:Chris Day|Chris Day]] 21:05, 22 October 2008 (UTC) (<small>for the record, I have removed it twice, Gareth has removed it twice, Howard has removed it once. Ramanand has added it back mulitple times.</small>)
:Odd, but I have written quite a few articles on differential diagnosis in medicine, and some of my most interesting professional work is in expert systems to "individualize" (e.g., what dosage forms are most convenient for the patient and are most likely to be taken on schedule? What other diseases are present -- are there synergistic as well as problem interactions? Are there patient preferences?  Are certain side effects more or less likely? Somehow, I manage to muddle through this sort of thing, yet I keep being told there are Inner Secrets to Homeopathy that prevent a straightforward explanation. Now, I'm not a classic layman in conventional medicine, but I can't think of a field where I don't have a basic understanding and the ability to quickly get a much deeper understanding -- and also know what I don't know. In the last six months or so, I've had to do the research to do peer interactions, on the specific diseases of people (two- and four-legged) for whom I'm an advocate and case manager -- involving [[human iron metabolism]], [[feline squamous cell carcinoma]], and [[peripheral nerve myelin protein 22]] and [[inflammatory polyneuropathy]]. But I can't begin to understand how a homeopath thinks?


:Add one more for Ramanand
:In fairness, I'm not sure how much time I'm willing to expend on homeopathy, at least unless I get comparable collaboration on less controversial, and possibly useful to more people, health science articles (to say nothing of other fields). [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:26, 4 July 2010 (UTC)
::"''[http://en.citizendium.org/wiki?title=Homeopathy&diff=prev&oldid=100400613 it was agreed to let this be, so why was it deleted? Use the Talk Page!]''"
:And one more for Howard
::"''[http://en.citizendium.org/wiki?title=Homeopathy&diff=prev&oldid=100400659 yes, do see the talk page. Chris, Gareth and I, have all removed it, and will keep removing it. With whom did you think you had an agreement?]''"
:This needs to be decided on the talk page. As yet, i see no agreement for the inclusion of this sentence. See above for reasoning. [[User:Chris Day|Chris Day]] 15:51, 23 October 2008 (UTC)


All homeopaths use it in acute Bronchitis (for both themselves and patients), not just me. I'll have to report this to a constable if the 'ground rules' laid down by Larry aren't followed.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:06, 24 October 2008 (UTC)
== Luc Montagnier ==


:Anything other than anecdotal evidence? [[User:Chris Day|Chris Day]] 03:40, 24 October 2008 (UTC)
French virologist Luc Montagnier has said at a prestigious international conference when he presented a new method for detecting viral infections that it bore close parallels to the basic tenets of homeopathy. This has been published in the 'Sunday Times' (London), as well as 'The Australian' - here's a link to the article: http://www.theaustralian.com.au/news/health-science/nobel-laureate-gives-homeopathy-a-boost/story-e6frg8y6-1225887772305
:I hope one of you (at least Dana) make time (I don't have the time) to insert this matter into this article.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:26, 5 July 2010 (UTC)
Here's another link: http://epaper.timesofindia.com/Archive/skins/pastissues2/navigator.asp?login=default&AW=1279125246109
—[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:37, 14 July 2010 (UTC)


::As Chris said, your unsupported word is not adequate. Even if you can put an available source next to it, it is also acceptable, within the ground rules, to put well-established medical guidelines for dealing with something of this type, and I believe that it can also be documented, from standard emergency medicine texts, that delay to definitive treatment of severe respiratory distress can be quickly fatal.  
::I certainly have no intention of amending the article with newspaper articles, especially those that indicate nothing but a "close parallel." Has Dr. Montagnier's proposal been discussed in mainstream journals? 


::Part of the problem is there is no understandable definition of the clinical picture of this patient. If you can, Ramanand, describe, in detail, the status of the patient. Even at the EMT-Basic level, I would expect respiratory rate, pulse, blood pressure, skin color, and a description of the visible and audible mechanics of breathing: stridor? cough? discharge? What's the age and body habitus of the patient? Any immediate significant history such as insect bite? Visible swelling?
::The first article, in ''The Australian'', mentions a "memory of water" type argument, and cites rejection by other scientists. I'd note that his Nobel was for virology, not physical chemistry. The second is behind a paywall. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:58, 14 July 2010 (UTC)


::At a more advanced level of training, I would expect much more. Since you haven't given any details, I'm going to assume a child, and quote from the eMedicine tutorial on stridor: "If distress is moderate to severe, further physical examination should be deferred until the patient reaches a facility equipped for emergent management of the pediatric airway."[http://www.emedicine.com/ped/TOPIC2159.HTM] You said "all homeopaths" use this. What are the qualifications and equipment of "all homeopaths" to manage an airway? Rapid sequence intubation? Cricothyrotomy?
:::Hi friends!  Actually, I got sent this link to a recent issue of the "New Scientists" by none other than Nobelist Brian Josephson:  <http://www.newscientist.com/article/mg20727682.300-60-seconds.html>


::The ground rules absolutely allow objective, sourced criticism to be side-by-side with a not-widely-aceepted assertion. I believe a reasonable interpretation would also consider that the patient presentation is so vague that no one versed in mainstream medicine can even begin a primary assessment. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:02, 24 October 2008 (UTC)
:::"Clear as a Nobel"
:::Luc Montagnier, the French virologist who won a Nobel prize in 2008 for linking HIV with AIDS, last week made controversial claims that highly dilute solutions of harmful viruses and bacteria emit low-frequency radio waves, allegedly from watery nanostructures formed around the pathogens. Similar claims have been made for homeopathic remedies."  [[User:Dana Ullman|Dana Ullman]] 17:40, 14 July 2010 (UTC)


Two points here.  First, if you spot edit warring going on (repeated insertion and deletion), please let me know.  As it appears everyone knows, a point should be fully discussed rather than allowing the edit war to go on, and if that does not result in a suitable compromise (is a compromise possible in this case?), then contact me immediately, please.  I will tell you in most cases that you must find a mutually agreeable compromise. While that is being worked out, one side must be big enough to let the text stand while the issue is discussed. If you need a way to decide ''that,'' I'd say to go with the editors--Gareth Leng is a healing arts editor.
::::That link goes to the daily news summary, not anything on homeopathy.  As quoted, though, they are "controversial claims". No details.  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:57, 14 July 2010 (UTC)


Second, to Howard, Chris, and Gareth, let me say that it seems to me that you need to decide what the problem with the disputed text is.  Gareth says the problem is that the text implies that homeopathic treatments should be made before conventional treatments, which is dangerous; Chris and Howard then say that the problem is that the mentioned treatment for bronchitis is idiosyncratic and not a common homeopathic treatment (or they are skeptical of this, on grounds unclear to me).  The two issues would require two different solutions.  If the problem is danger, then as I said below, the text needs to be expanded and clarified and surrounded with clear warnings from the point of view of conventional medicine.  If the problem is idiosyncracy (i.e., if it really is true that the mentioned treatment for bronchitis is ''not'' in common use by homeopaths), then the whole discussion of the treatment ''could'' be removed, and then there'd be no more problem.  But, obviously, some research will have to be done to settle the latter question. --[[User:Larry Sanger|Larry Sanger]] 14:57, 24 October 2008 (UTC)
:::::It is necessary to have that link in this article to show that homeopathic remedies are not 'placebos', as some people allege.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:40, 16 July 2010 (UTC)


:Very briefly -- one of the biggest question is "bronchitis", or sometimes "bronchitis and asthma" (which may or may not be related) is being used as if it is self-explanatory. Ramanand is not giving enough information to judge if the situation is potentially life-threatening, so a medically-oriented person is going to judge pessimistically. We also don't know what advanced life support equipment and skills are present in Ramanand's office. If he has suction, intubation, several standard drugs, etc., and is qualified to use them, that would be a different matter. Most office physicians in the U.S. do have such equipment, although it might be scary for someone to try to intubate, not having done it in a few years. Anesthesiologists and emergency physicians, and experienced paramedics make it look easy -- most of the time. Even they can have troubles. I know the principles of cutting through the cricothyroid membrane and establishing airway, but I'm not licensed for it and I hope I never am faced with the moral choice of being the only person in range that knows a maneuver that could be lifesaving. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:43, 24 October 2008 (UTC)
::::::It is another piece in the puzzle.  It is primary research, but it is by a Nobel Prize winner, so it is news about homeopathy. We shouldn't treat it as scientific fact, but it is a fact that a prominent scientist has made the statement that involves a quality of water. It is in no way scientific consensus, an in fact may lead to this guys ruin for whatever reason.  We have included news about the British Medical Association's recent position statement concerning homeopathy and [http://www.theaustralian.com.au/news/health-science/nobel-laureate-gives-homeopathy-a-boost/story-e6frg8y6-1225887772305 this article] specifically mentions that statement as well. This is the draft, so I won't categorically remove something that is written comprehensively, neutrally, and objectively about the subject. [[User:D. Matt Innis|D. Matt Innis]] 12:59, 17 July 2010 (UTC)


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


From the main article lead, I moved the discussion of "miasms" for a bit of reexamination.  The article text said <blockquote> Most also accept the concept of "miasms", a homeopathic concept of disease in which the symptoms of an organism’s imbalance indicate that a specific anti-miasmatic remedy is sometimes needed.</blockquote>
:My point in providing the link to the NEW SCIENTIST is to verify that this research is "notable," and as such, a short note is worthy here.  [[User:Dana Ullman|Dana Ullman]] 05:35, 21 July 2010 (UTC)


Purely from a standpoint of sentence structure, I look at that and say "huh?" What information is that sentence imparting? It seems completely circular and information free: a miasm seems to be a set of symptoms indicating that an anti-miasmic remedy is needed. No more, and no less, information would be conveyed if "evil", "trigonometry", or "''Francisella tularensis''" were substituted for miasm; there is no additional definition in the article.


In the current [[History of Homeopathy]] article, it is said Hahnemann defined  
::Matt, you are wonderfully reasonable.  Howard is not accurate when he says that Montagnier has "made an observation". Montagnier conducted RESEARCH, and he wrote about it in a peer-review journal. He spoke about it to a group of fellow Nobel Prize winners. And ALL of this was so notable that the "New Scientist" commented about it...and linked it directly to homeopathy. I have no problem if we choose to have the word "controversial" used in describing this new work.  The fact of the matter is that this new work discusses "electromagnetic signaling" which may help explain how homeopathic medicines may work. [[User:Dana Ullman|Dana Ullman]] 18:29, 9 September 2010 (UTC)
<blockquote>three fundamental 'miasms' underlie of all the chronic diseases of mankind: 'Syphilis', 'Sycosis' (suppressed gonorrhoea), and 'Psora'. Miasma, from the Greek for 'stain', was an old medical concept, used for "pestiferous exhalations". In Hahnemann's words: "...a child with small-pox or measles communicates to a near, untouched healthy child in an invisible manner (dynamically) the small-pox or measles, … in the same way as the magnet communicated to the near needle the magnetic property..."</blockquote>


Again, I must say, "huh"? ''[[Treponema pallidum]]'', ''[[Neisseria gonorrheae]]'', and something else underlie all the chronic diseases of mankind? True, [[gonorrhea]] is showing multidrug resistance, but, by the April 2007 CDC recommendations a single intramuscular dose [[ceftriaxone]], 125mg., should kill two-thirds of the ills of mankind. Not sure about "Psora" though; Is there a more modern name for it? [[Variola virus]] and [[Measles virus]] don't have anything to do with transmission of the others?
:::Then why isn't the peer-reviewed journal cited, rather than ''Wired'' and ''The Australian''? Further, one may write (e.g., an editorial) ''in'' a peer-reviewed journal, but not have one's work peer-reviewed ''by'' that journal. The peer review process becomes more credible if another independent researcher reproduces of these results.  Please provide citations of these events if you want me to believe this is substantive.


May I assume that homeopaths accept [[Koch's postulates]], by which cause and effect of everything except psora have been thoroughly demonstrated? If not, I think it's important to have it stated just what homeopaths do, or do not, believe about [[infectious disease]]. If homeopaths don't believe in it, that's their privilege, but an encyclopedia article needs to make a clear statement of that.
:::Nobel Prize winners, rather by definition, tend to be specialists. One might speak on medicine to a group of Chemistry laureates, and have no special critical review.  


Now, if these are symptom complexes and homeopaths agree have nothing to do with the pathogens mentioned, fine. If that is the case, then if miasms stay in the article, could we have a definition of the symptoms? Sorry, if the answer is "it's too hard to explain to a non-homeopath", even people with a bit, here and there, of biological background, it is too hard to have in the article.  
:::It's interesting that we are still arguing how homeopathic medicines "may" work, when it's rather routine to understand the molecular pharmacology of conventional medicines. Sorry, this still comes across as hand-waving for something with a trivial base of evidence.


There is nothing wrong with this article having clearly stated homeopathic beliefs, with a notation that the belief is incompatible with mainstream thinking. If the belief cannot be stated well enough to be evaluated, then there is a problem. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:28, 24 October 2008 (UTC)
::::Have I fired five or six rounds? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:38, 9 September 2010 (UTC)


== Ground rules, criticism, and removal with no discussion ==
== Evidence that homeopathy works ==


It is a goal of Citizendium to avoid "encyclopedese", while presenting different views fairly. Toward the end of the article, I placed, with appropriate disclaimers, an assessment from a reputable source, who emphasized that to use, or not to use, is an individual choice &mdash; but one that he himself would not take.
I hope one of you (at least Dana) can insert sentences that read something like, "there is scientific evidence for homeopathy", using the PDF for "Scientific framework of homeopathy: evidence-based homeopathy" available at http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/286/354 wherever appropriate. I haven't seen anyone object to it here anyway.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:15, 21 July 2010 (UTC)


'''My emphasis''' on introductory comment to emphasize individual choice; <u>Sagar's agreement</u>, in the "quote from current article"
== the word "skeptic" ==


"While he is a critic of homeopathy, and '''this quote is not intended to say that homeopathy is or is not a placebo effect, Sagar sums the choices''' with a bit of humor:<blockquote><u>The choice is entirely with the individual.</u> Those who believe in the power of undetected subatomic fields may continue taking homeopathic medicine with an excellent placebo effect, but at a financial cost that cannot be ignored. Those who maintain faith in today’s science may continue to see their physician and receive conventional medication proven in clinical trials, rather than in succussion. However, if you choose to save money and avoid side effects, a teaspoon of honey (composed mainly of sugar and water) may be more attractive—unless, of course, you are allergic to bees or pollen.</blockquote>"
Wasn't it decided a long time ago that aside from the two existing examples in the article that pro-homeopathy advocates (and anyone else) could NOT use the word "skeptic" in future edits?  Just want to make sure. [[User:Hayford Peirce|Hayford Peirce]] 21:50, 5 August 2010 (UTC)


<nowiki><ref name-Sagar2007>{{citation
:I remember that as a specific ruling by Larry. In my experience, it's almost always used by advocates of a position; the neutrality policy wouldn't be hurt if it were banned. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:41, 5 August 2010 (UTC)
<ref name-Sagar2007>{{citation
| url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1948865
| author=Sagar SM
| year = 2007
| title = Homeopathy: does a teaspoon of honey help the medicine go down?
| journal = Curr Oncol
| volume = 14
| pages = 126–127}}</ref> </nowiki>


Ramanand removed that material, without discussion, just an edit note saying he was replacing a critic with a "fact". I agree that the material below is a fact, and it would not have been unreasonable to add the comment.
::But what about people who ''are'' skeptics? Are we not allowed to say that Michael Shermer - who runs the Skeptic's Society and publishes ''Skeptic'' magazine - is a skeptic? –[[User:Tom Morris|Tom Morris]] 23:02, 5 August 2010 (UTC)


<blockquote>Qualified health professionals practising homeopathy, on the other hand, believe they can not only diagnose the disease, but also treat it.</blockquote>
:::As a direct quote or a self-identification, sure. As condescension to disbelievers, no. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:04, 5 August 2010 (UTC)


It would be equally reasonable to respond to this with a comment that mainstream physicians seriously doubt homeopaths can diagnose or treat disease, which would seem self-evident given their claim that there is no such thing as disease, only individual complexes of symptoms.
::::Ah, but is it? I consider 'skeptic' to be much less of an insult than 'homeopath'! –[[User:Tom Morris|Tom Morris]] 23:06, 5 August 2010 (UTC)


Personally, I think Dr. Sagar summed up the individual choices quite nicely. If there is a homeopath with a similar flair for words, I'd be delighted to see it here.
:::::I think it is -- it comes up repeatedly in fringe articles, be they moon landing hoax, UFO, etc. -- anything not a true believer. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:13, 5 August 2010 (UTC)


Call whoever you like, Ramanand. The ground rules say that homeopaths can say what they believe, and it would have been appropriate for you to add that &mdash; and for someone to make an alternate statement. There is absolutely nothing in the ground rules that bars criticism, especially when the "critic" freely acknowledges that people may choose homeopathy. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:21, 24 October 2008 (UTC)
::::::If *I* use the word, Tom, it's a compliment. If Dana uses it, it's pejorative.  That's why Larry (or someone) banned it from this article, if I recall correctly. (I have 20 years' of Skeptical Inquirer on my bookshelf.) [[User:Hayford Peirce|Hayford Peirce]] 23:21, 5 August 2010 (UTC)


:Ramanand, this is a ''perfect'' application of the rule that criticisms must be allowed. You are absolutely not free to remove such criticisms. --[[User:Larry Sanger|Larry Sanger]] 14:31, 24 October 2008 (UTC)
== What the...? ==


==Controversial text==
<blockquote>Homeopaths respond to these concerns by noting that using homeopathic medicines can delay or reduce the use of conventional medicines that are ineffective and dangerous.</blockquote>
The text that is subject to an edit war is the following
"Situations for which homeopathic practitioners work in a manner complementary to that of conventional medical practitioners include [[asthma]] and [[acute bronchitis]], where immediate and certain temporary relief from [[metered-dose inhaler]]s, [[nebulizer]]s, or [[parenteral]] [[drug]]s is sometimes necessary, '''if homeopathic remedy selection is going to take time.'''
I have deleted and will continue to delete the section in bold, because it implies that homeopathic treatments are an effective substitute for conventional, effective drugs, and suggests that this is accepted by conventional medical practitioners. Homeopaths are '''not'''working in a manner complementary to conventional medical practitioners if they are substituting homeopathic remedies for conventional approaches rather than providing remedies as adjuncts to conventional treatment. What I cannot accept in this article is a) anything that looks like treatment advice b) anything that suggests that homeopathic remedies are considered by conventional practitioners to be an acceptable substitute for conventional treatments. The text as written suggested that a) homeopathic remedies might be acceptable substitutes and implied (by the use of the word complementary) that this was accepted by medics.


:I am happy for a statement to appear that homeopaths '''do''' use remedies as substitutes for conventional treatment even when the conventional treatment is known to be effective and urgently indicated; perhaps this statement is needed and should be inserted. That must be followed directly by a statement strongly dissociating conventional medical opinion from such practices.
If this were The Other Wiki, that'd be an instant "citation needed"! I know homeopaths like to bang on about the evil 'allopaths', but do they honestly respond to the [[opportunity cost]] argument with a reversed opportunity cost argument? That's so... indescribably crazy. I certainly would like some verification on that. –[[User:Tom Morris|Tom Morris]] 00:42, 6 August 2010 (UTC)
[[User:Gareth Leng|Gareth Leng]] 11:04, 24 October 2008 (UTC)
:Remember our motto: '''be bold''' -- remove it, and let whoever put it there back it up with some facts if they want to restore it. [[User:Hayford Peirce|Hayford Peirce]] 01:42, 6 August 2010 (UTC)


::I concur. Not suggesting that homeopaths do or do not do this, but the thinking has to be understood. Knowing if the approach will be optimistic (the body will usually heal itself) or pessimistic (the patient's airway could block completely in the next minute -- what do I do?) would help. [[User:Howard C. Berkowitz|Howard C. Berkowitz]]
::Oh, now we're bold, haha. It's a response to the use of homeopathy for use with things like childhood ear infections, a commonly self limiting condition that is often treated with antibiotics which have unwanted and sometimes dangerous side effects. It probably could be explained a little better when it's all cleaned up. After all, that is the homeopath response. [[User:D. Matt Innis|D. Matt Innis]] 21:50, 7 August 2010 (UTC)


Isn't this just a matter of crafting a slightly longer text?  Surely we can write something to the effect that, while (1) some homeopaths will sometimes advert to conventional treatments for bronchitis if homeopathic treatments will take too long (i.e., place the patient at risk, by waiting), (2) conventional physicians strongly insist that the conventional treatment for the condition be done immediately, and that any homeopathic treatment be done as an adjunct. Have I got that right?
:::On the other hand, I can point to many medical studies advising against antibiotics in uncomplicated otitis media. Going back to Osler at the turn of the 20th century, he correctly pointed out that "allopathic" drugs were often harmful -- but he then said both homeopathy and (classically defined) allopathy were "cults" that needed to be replaced. One doesn't need to turn to homeopathy to find best practices that avoid both overprescribing and underprescribing. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:59, 7 August 2010 (UTC)


We should, of course, allow homeopaths to state how they treat bronchitis.  But, if conventional physicians find this treatment actually dangerous, it is just as obvious (or more so) that we must place in blinking lights (so to speak) warnings to the effect that conventional physicians find the treatment to be dangerous.  Moreover, we should say ''why'' we find that dangerous. There is no point to skirting around the issue of why it is considered dangerous by conventional physicians.  Spelling out the danger is essential to understanding the full range of thinking on the issue. --[[User:Larry Sanger|Larry Sanger]] 14:20, 24 October 2008 (UTC)
::::Yup, absolutely agree. [[User:D. Matt Innis|D. Matt Innis]] 01:10, 8 August 2010 (UTC)


: I think you have got it right; I'm hesitating to alter the text myself first because I don't know myself that homeopaths generally would delay conventional treatment, and until I understand exactly in what conditions they might delay treatment, it would be premature to contemplate the possible consequences. I can be certain that conventional physicians would consider any delay in treatment to be disadvantageous, whether there is any evidence that it might pose real risks I'm unsure of. It depends. I'm more concerned aboutthe message for acute asthma "A severe asthma attack is a life-threatening emergency that requires immediate, skilled, professional care. If not treated adequately and quickly, a severe asthma attack can cause death." [http://respiratory-lung.health-cares.net/control-asthma-attacks.php]. We really cannot give the impression that such attacks can be treated by homeopathy; to do so would be irresponsible.[[User:Gareth Leng|Gareth Leng]] 15:02, 24 October 2008 (UTC)
== principle of infintesimals ==


::Clearly, we need to hear more from Ramanand, or perhaps Dana. In the meantime, I think you as Healing Arts Editor would be justified in removing the problematic text ''provisionally and subject to discussion.'' --[[User:Larry Sanger|Larry Sanger]] 15:21, 24 October 2008 (UTC)
I'm thinking that [http://en.citizendium.org/wiki?title=Homeopathy%2FDraft&diff=100701656&oldid=100701655this principle] needs defining.  I'm thinking that the 'principle of infintesimals' is the concept that is controversial.  Perhaps one of our homeopaths could explain? [[User:D. Matt Innis|D. Matt Innis]] 12:32, 12 August 2010 (UTC)
:Throughout this article, the infinitesimal dose and law of similars have been used interchangeably, but they aren't the same. http://www.similima.com/org20.html has given a brief description of the "infinitesimal dose". The law of similars is just, "using the most similar remedy" - to put it plainly. I don't have the time to check and insert those changes, but I hope you Matt, or may be Dana can do so. The infinitesimal dose can also be defended with the "memory of water" and Monsieur Montagnier's research (see Dana's post above).-[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:49, 13 August 2010 (UTC)
::Certainly using them interchangeably is not accurate. [[User:D. Matt Innis|D. Matt Innis]] 15:05, 13 August 2010 (UTC)
:::I think the term "interchangeably" was wrong to use - what I meant was that the term "law of similars" is used in the article and draft article, when it's supposed to be "the infinitesimal dose", in some places.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:50, 13 August 2010 (UTC)
::::So it seems to me that infinitesimal dose needs to be defined. The law of similars can obviously involve large doses of products.  Obviously Homeopaths use more than infinitesimal doses in their treatments; otherwise we wouldn't have side effects from a nasal product that has zinc in it. We are not getting this point across. [[User:D. Matt Innis|D. Matt Innis]] 17:47, 13 August 2010 (UTC)


:::Many of these blinking lights are on, in [[#Text reverts on 12 October...ongoing]]. I don't think you want books on management of emergent respiratory distress, so I'll just repeat something from up there; more specifics available if you want. I don't know this patient has stridor, but I don't have enough information to know he doesn't.
::::<font color=red>I don't think it's worth the time, since that will also be criticized here (maybe you can use the web-site I mentioned above to do that). The nasal product, "Zicam" wasn't a homeopathic product at all, because it had milligram doses of zinc, which is against homeopathic principles. Homeopathic remedies start with mother tinctures and can go up to higher potencies (more dilute) from there.</font>—[[User:Ramanand Jhingade|Ramanand Jhingade]] 09:50, 23 August 2010 (UTC)


:::<blockquote>"If distress is moderate to severe, further physical examination should be deferred until the patient reaches a facility equipped for emergent management of the pediatric airway."[http://www.emedicine.com/ped/TOPIC2159.HTM]  
:::::Zicam was marketed as homeopathic, and licensed under special regulations applying to homeopathic products. Sorry, for legal purposes in the US, it ''was'' a homeopathic product. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:49, 24 August 2010 (UTC)


:::At the EMT level, from ''Emergency Care and Transportation of the Sick and Injured (4th ed)'', a standard EMT text from the American Academy of Orthopedic Surgeons, speaking of a patient in the field, in moderate respiratory distress of uncertain etiology:<blockquote>In the absence of coma, the EMT must be prepared to handle the production of large amounts of mucus with appropriate suctioning, and administer oxygen. If the patient is in a coma, airway maintenance may be needed. Occasionally, full CPR is required for an episode of anaphylaxis. (p. 333)</blockquote>
:::::<font color=green>I know it was, but it was against homeopathic principles.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:39, 25 August 2010 (UTC)</font>


:::I'd be much more comfortable saying "sure, try homeopathy, it doesn't seem to be an emergency" if I had enough history and physical to make that as a reasonable decision. Obviously, thousands of physicians handle mild respiratory distress in their offices every days. Most physician offices, however, also have a considerable amount of advanced life support equipment in a closet. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:24, 24 October 2008 (UTC)
(undent) Please do not use color for emphasis.


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


Sometimes, as I was just telling Howard ;-) , the sheer quantity of text on the talk page gets in the way of our properly communicating.
With all things that it approves, the FDA depends on the manufacturer's application.  More is accepted is fact in a homeopathic New Drug Application that isn't required to undergo controlled trials. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:57, 5 September 2010 (UTC)


So let me state very briefly what I want.
== Answer to an "unanswered question": Popularity is no metric of efficacy ==
* Ramanand, please answer this question: what do you mean by bronchitis?  If "bronchitis" is not adequately descriptive, then, in more words, what sort of condition are you saying here that homeopathy can treat?
* Also please answer this: do you believe that homeopathy is a suitable treatment alone, in cases of emergency situations, in which the patient is faced with imminent death without effective treatment?
* Once we have these questions answered from Ramanand, I propose that someone who understands the issues (maybe Gareth) write a compromise text.  Maybe a "compromise" won't be necessary because we'll realize that this was a big misunderstanding.
--[[User:Larry Sanger|Larry Sanger]] 16:06, 24 October 2008 (UTC)


::: Thanks Larry. I've done some hunting and it is clear that Ramanand is right in that homeopaths do indeed widely recommend their remedies for acute asthma attacks in the first instance; it's not an isolated practise but widespread. It is also clear that conventional medical organisations are concerned enough to issue warnings to patients that there is no evidence that these homeopathic remedies are effective and that it might be dangerous to substitute these for conventional treatment (I've given two examples of links). So I've modified the text to try to follow Larry's very sensible guidance here.[[User:Gareth Leng|Gareth Leng]] 16:57, 24 October 2008 (UTC)
Sorry, but the addition "The simple reason for homeopathy's growing popularity is because it works." is completely unacceptable without overwhelming evidence that it does work.  Were this to be accepted without sourcing, the logic could be applied to popularity of politicians, especially not in office, supporting the premises their programs work.


:Homeopaths are not wrong in thinking of Hippocrates' maxim, "first, do no harm". Especially in emergency medicine and trauma, the outstanding people I know are not necessarily taking drastic steps, but are, rather like a fighter pilot or chess player tries to stay ahead of his opponent, constantly thinking "I'll wait for now, or do this for comfort...but I must be ready if A or B or C suddenly happens".  
I propose to delete this. Popularity is relevant to marketing but not efficacy. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:48, 24 August 2010 (UTC)


:It has not come across, and may be a misunderstanding, that homeopaths start conservatively and want to thoroughly exhaust each remedy before trying something else. I simply have no sense to what extent they are thinking ahead -- both in knowledge and preparation -- of ''potential'' catastrophes. I take a lot of advice from the writings of Ken Mattox, who is probably the dean of trauma surgery. Ken not only has the judgment, but the incredible teaching skills, to get across when watchful waiting is appropriate, and when fast and drastic action is necessary. It wasn't with him, but only once have I seen a chest opened in a hallway (I'd prefer not to watch it again); the patient had a gunshot wound to the chest, with pulse stopping in the ambulance that did a lot of other correct things (such as "scoop and RUN"). Saved the patient, but a minute or two of hesitation would have been too long. Without manual heart compression, the patient didn't have enough blood to pump to the brain.
:Those questions were begging for an answer. If you delete my answer, you must delete the questions preceding my statement as well!—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:45, 25 August 2010 (UTC)


:I may be too busy for the next few hours, but I'll try to do a starter article on assessment and emergency management of respiratory distress, from the perspective of emergency medicine.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:33, 24 October 2008 (UTC)
::Your statement, unsourced, was not an answer. It was purely your opinion, phrased as informal commentary. Also, it is a rather sweeping opinion that goes to the heart of the article, with no evidence behind it. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:45, 25 August 2010 (UTC)


::: Thanks Gareth, Howard and Larry, I hope things are resolved now.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:36, 25 October 2008 (UTC)
:::While Howard is right in saying that "popularity" is not a metric of efficacy, popularity is (by definition) its own metric, and statistics about homeopathy's popularity now and in the past has a place in an encyclopedia.  Further, I give reference to a half-dozen
surveys that further verify that people who tend to receive homeopathic care tend to be more educated than those who don't.


Friends, I am concerned that Gareth above says that there is "no" research that shows any benefits from homeopathic medicine in the treatment of acute asthma. In the future, it might be better to ask IF there is such research first before making such a categorical statement...and/or one might consider doing some searches.  Below is some info from my ebook that references 150+ clinical trials.
:::The following link to an article that I authored provides references to this information (please know that I am not suggesting that we link to this article but only to use the references in this article in our encyclopedia listing: http://www.huffingtonpost.com/dana-ullman/homeopathic-medicine-euro_b_402490.html [[User:Dana Ullman|Dana Ullman]] 19:14, 9 September 2010 (UTC)


Research conducted by professors at the University of Glasgow indicates that those patients given exceedingly small homeopathic doses of whatever substance to which they are most allergic can experience significant relief within the first week of treatment (Reilly, 1994). The authors called this unique method of individualizing medicines "homeopathic immunotherapy." 
::::''Post hoc, ergo prompter hoc?'' I can give even more studies that verify more people who drink milk become heroin addicts. Popularity is a principally a metric of efficacy -- of marketing. If it is significant here, Lady Gaga should be even more expert than Dana, and probably has a better figure. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:20, 9 September 2010 (UTC)


:::This double-blind, placebo-controlled trial showed that over 80% patients given a homeopathic remedy improved, while only 38% of patients given a placebo experienced a similar degree of relief.  A homeopathic physician and a conventional physician assessed the patients.  When the patients and doctors were asked if they felt the patient received the homeopathic medicine or the placebo, both the patients and the doctors tended to guess correctly. 
== Allopathy ==


:::The experiment was relatively small, with only 24 patients.  In order for statistically significant results, such experiments must demonstrate a very large difference between those treated with a medicine and those given a placebo.  Such was the case in this study.
"Today, "allopathy" is used by practitioners of alternative and complementary medicine, like homeopaths, osteopaths, naturopaths, chiropractors and so on to refer to conventional, western medicine."


:::The researchers utilized conventional allergy testing to determine the substances to which the asthmatic patients were most allergic, and then gave a 30th potency of this substance to half of the subjects (neither the experimenters nor the subjects knew who was given the medicine and who was given a placebo).
Since practitioners of conventional, western medicine rarely use the term, however, there's no good argument to insist on calling them allopaths. Yes, there are a few historical references, especially when talking of osteopathic vs. allopathic medical schools, but the term used by conventional western physicians tends to be...conventional western physicians.


:::A double-blind, randomized, placebo-controlled trial was conducted in Cuba on patients with bronchial asthma (Riverson-Garrote, 1998). In this study 63 patients (34 children and 28 adults) participated, 39 of whom were given individualized homeopathic treatment and 24 were given a placebo. 
Ramanand, if I refused to call you anything other than Jean-Paul, would that change your name? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:57, 24 August 2010 (UTC)


:::In the treated group, 97.4% improved and 2.6% worsened.  87.2% reduced their use of conventional medication. In the placebo group, 12.5% improved, 16.7 stayed the same, and 70.8% worsened.  None of the subjects given a placebo reduced their conventional medication.  
:Practitioners of alternative and complementary medicine, like homeopaths, osteopaths, naturopaths, chiropractors and so on refer to conventional, western medicine as "allopathy" even today. If you don't like it, you can add something like, "conventional, western physicians do not refer to themselves as allopaths".—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:50, 25 August 2010 (UTC)


:::Another study prescribed a homeopathic combination remedy (a mixture of various homeopathic medicines) to asthma patients who were dependent upon corticosteroid drugs.  This double-blind, placebo-controlled randomized study treated 40 asthma patients on corticosteroid drugs, and it showed that the 20 patients given the homeopathic medicine experienced greater improvement than those given a placebo and were able to reduce the dosage of their conventional drugs (R. Matusiewicz, 1997).  
::Each profession defines what it calls itself. That is not the role of other professions. Would you accept the specific words "practitioners of conventional western medicine call homeopaths frauds?"  No? Then why do you have the right to define a name, regarded by many as either historically inaccurate -- they don't use the principle of opposites -- or a sneering attack?. I wouldn't have the slightest objection if homeopaths called themselves Similarists, Hahnemannists, etc. -- but that is how they characterize themselves, not how they characterize others. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:44, 25 August 2010 (UTC)
===Ruling needed===
Mr. Jhingade reinserted "although osteopaths, homeopaths, naturopaths and other alternative medicine practitioners continue to call it allopathy." I will remove this unless an Editor says otherwise, as I believe it has been ruled that one discipline is not permitted to define a name for another. Shall I say "although biologically-oriented scientists consider homeopaths to be quacks? (noise made by the simillium of [[Oscillococcinum]], of course)"  At best, this might go in the [[allopathy]] article.  


:::A study in Norway of 200 patients suffering from hypersensitivity illnesses, including asthma, eczema, urticaria, hay fever and other allergies, showed that homeopathy was at least as effective as conventional medical treatment (Launsø, Kimby, Henningsen, 2006). The study was retrospective and comparative, and it evaluated everyday clinical practice of general practitioners and classical homeopaths. Most patients who were treated by conventional medical doctors experienced an aggravation of their symptoms when stopping conventional drugs, while only 1/3 of patients in the homeopathy group experienced such an aggravation (P = 0.002). Only one patient on conventional treatment experienced improvement of symptoms after stopping medication, compared to improvement in 2/3 of homeopathy patients. Patients in the homeopathic group also reported a larger improvement in their general state of health, with 57% improving, compared to 24% in the conventional group (P=0.004). Homeopathic patients also experienced substantially more positive change in their psychological state (P<0.0001). For quality of life 53% in the homeopathy group improved, compared to 15 % in the conventional group.  
Osler deprecated both allopathy and homeopathy by the time of the Flexner report, although, somewhat earlier, he had attacked some of the drugs used by self-descibed allopaths. I'd note the latter was 19th century.


REFERENCES:
Be very careful, incidentally, in using "osteopath" versus "osteopathic physician". The latter, in the US, does use "allopath" but in a very narrow context dealing with the history of schools. Undergraduate and graduate medical education from traditionally "osteopathic" or "allopathic" education is largely identical, although some additional manipulative techniques may be taught in ''some'' historically osteopathic programs -- or by qualified faculty in historically "allopathic" programs. Assuming equal certification,  with many boards merging, the scope of practice of DO's and MD's are identical.  U.S. osteopathic physicians do not use the term allopathy in regular practice. Indeed, I know a few that don't use manipulation or any special osteopathic methods. As an aside, in the state of Virginia, to perform acupuncture, one must be licensed as a physician; the two I used were, respectively an MD with a OMD degree from Vietnam and a OB/GYN certification from FACOG; the other was an DO internist board-certified in internal medicine.
Launsø L, Kimby CK, Henningsen I, Fønnebø V. An exploratory retrospective study of people suffering from hypersensitivity illness who attend medical or classical homeopathic treatment. Homeopathy (2006) 95, 73-80.  


Matusiewicz, R, “The Effect of a Homeopathic Preparation on the Clinical Condition of Patients with Corticosteroid-dependent Bronchial Asthma,” International Journal of Biological Therapy and Integrated Medicine,  1997,15:70-4.
In the UK -- I can't speak authoritatively  for the rest of Europe -- osteopathy is indeed a CAM discipline and its practitioners' scope of practice is not the same as a physician.  


Reilly, D, Taylor, M, Beattie, N, et al., "Is Evidence for Homoeopathy Reproducible?" Lancet, December 10, 1994, 344:1601-6. 
I would add that the opinions of naturopaths are irrelevant to this article.


Riveron-Garrote, M, “Ensayo clinico aleatorizado controlado del tratamento homepatico del asma bronquial,” Boletin Mexicano, 1998,31:54-61.[[User:Dana Ullman|Dana Ullman]] 14:46, 25 October 2008 (UTC)
Could we please stop refighting this revert battle?  My impression is that rulings have been made.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:30, 5 September 2010 (UTC)


::Thanks Dana. I didn't say there was no research, I did say that medical organisations advise patients that there is no evidence that the remedies are effective - obviously that is their summary overview - that on balance, the evidence isn't there to support a recommendation to take homeopathic remedies for asthma. That's also the message from Cochrane. Obviously, some individual studies report positive findings, but my purpose was not to weigh the evidence but just to report the medical attitude. My main purpose was to mark that for asthma medical organisations do not consider homeopathic remedies to be an acceptable alternative to conventional drugs, and stopping conventional drugs or delaying administration in acute attacks is potentially dangerous.[[User:Gareth Leng|Gareth Leng]] 16:29, 27 October 2008 (UTC)
:Practitioners of alt. med. still call it allopathy (Look at the American Association of Osteopathic Physicians web-site, the National Center for Homeopathy web-site and so on). I'm sure Dana will support me on this one. I'm looking forward to a ruling too and I believe such a ruling will support the homeopaths' viewpoint, because this article is titled Homeopathy and not, "Criticism of Homeopathy".—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:44, 6 September 2010 (UTC)


:::Gareth, I understand, but now you see that medical organizations commonly use biased and inaccurate information about research.  When they asserted that there was "no" research, they committed this common error. The word "no" is absolute.  I hope that you can help this article acknowledge common biases in other places as well. [[User:Dana Ullman|Dana Ullman]] 01:17, 28 October 2008 (UTC)
::If you are arguing from the perspective of the American Association of Osteopathic Physicians, you are either ignorant of the historical reason they do that, or deliberately making a false argument that American osteopathic physicians, as distinct from osteopaths in Europe, are in any way "alternative". DOs pass the same undergraduate and graduate certifications as MDs.  I suppose I'll have to remind one of my DO friends, a world authority on field and disaster medicine, that he's "alt" and the surgeons shouldn't listen to him. If nothing else, there ''is'' a distinction between alternate and complementary.


::::To me, it feels like the main point is drifting away. Whether or not homeopathy has done no, some, or huge amounts of research is irrelevant to the point that certain specific respiratory distress presentations are potentially fatal in minutes to hours.  
::As far as the National Center for Homeopathy website, what part of "one discipline doesn't specify what another calls itself" do you fail to grasp?  I'm sure I can find medical sites that call homeopaths frauds and quacks; would you accept that designation? I'd have to go back into the archives, but I seem to recall that Larry ruled on this a long, long time ago. Dana does not have any editorial authority over what non-alternative practitioners call themselves.  


::::If someone claims to be a healthcare provider, and presumes to treat respiratory distress yet cannot recognize, or denies, the existence, of anaphylaxis or severe asthma, I believe there is an applicable legal term: "depraved indifference to human life." The existence of these and other life-threatening conditions, to which there are well-defined immediate-priority interventions, is not, to me, a matter of research. I don't think there is an unreasonable medical bias that putting a heavy-caliber bullet through the back of the neck is likely to be fatal. I don't think there is an unreasonable medical bias that anaphylaxis and status asthmaticus are real, need immediate treatment, and need different immediate treatment.
::If you think these comments are "attack on homeopathy", I refer you to the commentary of Dirty Harry Callaghan regarding the .44 Magnum. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:46, 7 September 2010 (UTC)


::::The point about research strikes me as a diversion from what, I believe, concerns Gareth, Chris and me. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:34, 28 October 2008 (UTC)
== Matt's reversions ==


===Asthma===
Matt, I see you have already reverted what I had added. I don't want to indulge in any "edit warring", so please restore what I had added. I have mentioned the reasons in the sections preceding this.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:20, 25 August 2010 (UTC)
Just to be sure that we aren't drifting from the immediate point of discussion, first, several of us are very concerned about homeopathic attempts to treat acute respiratory disease, when a prudent mainstream physician would consider the specific presentation one that may require hospitalization or be an immediate threat to life. I would note that there has been an enormous change in the medical management of asthma over the last roughly 30 years.


In a new section, I did put some comments where there might be some possible areas for better communications. They are worth thinking about, when discussing the significance of research.
:Since you merely identify this a "Matt's reversions", it's difficult to what you specifically have in mind. Did Matt move the questionable material here for discussion?  If he did, then it's appropriate to discuss it here, within policy limits, before it goes back.


Let me put some dimensions on asthma, only one of many respiratory diseases of concern to evidence-based medicine. My primary reference here is the Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma under the [[National Institutes of Health]], with 2007 updates. Main page is http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Some dimensions, mostly from 2005 health statistics for the U.S.:
:If he deleted without making it clear what he was deleting, or why he was making a Healing Arts Editor decision to delete it, he needs to put it here. Otherwise, you cannot simply demand that it be put back without consensus or an Editor ruling. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:51, 5 September 2010 (UTC)


*22 million people have been diagnosed with asthma. Many have well-controlled disease. Many do not.
:I'm in a hurry, but will make a quick reply. I hope Matt brings things here for discussion in future.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:38, 6 September 2010 (UTC)
*It affects approximately 6 million children
*There are roughly 497,000 hospitalizations annually


While all of these patients are not in clinical trials, it does give some idea of the statistical universe being measured. The EPR3 guideline described some community meta-analyses as "large" with 6000+ patients, but these are often dealing with refinement. Anecdote is not the singular of data, but I have watched quite a few people change from near-invalids when asthma therapy, a couple of decades ago, was based around bronchodilators, and perhaps immunotherapy. The revolution has been treating it as an inflammatory disease, and also providing more education and tools for self-management.
== "Attack piece" ==


I have not yet read the specific papers you cite, but the largest population appears to have been 200 patients "suffering from hypersensitivity illnesses, including asthma, eczema, urticaria, hay fever and other allergies". As far as I know, most recent medical studies use a quite specific definition of asthma, and deal with asthma alone, usually with a fairly standard treatment protocol as the control arm, because, to use your term, external validity has been well demonstrated of some standard therapies. We can always do better.
The statement "Some other researchers claim that there is scientific evidence that homeopathy helps in many problems and diseases[3]" was added with the edit note that "the lede can't be an attack piece."


Asthma, in part, is a disease of economics. It gets very interesting to plot severe disease against income, noting whether or not the patients are able to get the maintenance preventive medications. Poverty can get in the way of removing some well-understood allergens, such as dust mites.  
The lede also cannot be a place where non-substantive opinion can be used to "neutralize" the main thrust of expert opinion. Again and again, it's been pointed out that CZ's current neutrality policy does not mean that equal emphasis must be given to each position.


So, I'll cheerfully agree that it is incorrect to say there is "no" homeopathic research into asthma. Put that in, along with the sizes of the populations, and there can be side-by-side references to EBM trials, noting the sizes and specific criteria. It may also be useful to compare and contrast therapy over time, especially since the consensus was reached that the core of care for moderate to severe asthma was an anti-inflammatory regimen against a hyperimmune disease, and that too-frequent use of rescue bronchodilators was a possible indication of poor treatment.  
I recommend deletion of the above statement as far too general, and, for that matter, worded in a manner that really doesn't counter but says "well, yes but..."  There's an old medical story about a radiologist who crawls, bloody and battered, into his emergency room.  Asked what happened, he said it was "consistent with being mugged."  Things in the lede need a bit more substance than "consistent with."  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:19, 5 September 2010 (UTC)


With this little data, I would not dream of switching a well-controlled asthmatic, whom I cared about, from a working regimen to a homeopathic one based on mechanisms I can't understand. That regimen is based on a very comprehensive understanding of the pathophysiology of asthma and exactly where different drugs &mdash mast cell stabilizers, corticosteroids (primarily inhaled and limited to the airway), leukotriene antagonists, etc &mdash; work to prevent attacks. There is always room to improve. The role of long-acting beta-adrenergic agonists is much less clear than it first seemed.
:I don't see any probs with that ref and I'm sure Dana, the only other Homeopath here will support me on that.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:34, 6 September 2010 (UTC)


I will agree with you that there is some research. I will not agree that there is a clear theoretical basis for it, or a sufficiently large sample size, to overturn the recommendations of the large-scale consensus panels. Complementary homeopathic treatment could well be the subject of trials, but homeopathic alternative therapy for significant respiratory disease is a nonstarter for most people with a substantial evidence-based medicine background. The article can mention both points of view. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:40, 25 October 2008 (UTC)
== Similars and "allopathic drugs" ==


:Howard, you've shown yourself to be a diligent researcher on the internet, and I'm appreciative of that.  However, I hope that you realize that it is more challenging to be an accurate researcher (heck, we ALL make mistakes...I'm certainly not immune).  My point is that if you chose to do a review of some of the above studies on asthma, you would have found that 1994 Lancet study that treated asthma patients with homeopathic doses of whatever substance the asthma patient was most allergic, based on conventional allergy testing. It would seem that you of all people would acknowledge that there IS a CLEAR theoretic basis for the use of small doses of allergens to provide some clinical benefits (the difference in this study was simply that the doses of medicines used were in the 30C homeopathic dose.  Although this trial was relatively small (28 subjects), the high statistical significance required a substantial difference between placebo and control groups. 
First, I contend there is no such thing, in modern terms, as an allopathic drug.  Got any references, such as Goodman and Gilman, that use the term?  No, homeopathic texts don't get to define practices in general medicine. Taking a recent addition that I believe must be either radically changed or updated, I quote:


:While YOU may not want to risk homeopathic treatment, other people are tired of the risks (and sometimes inefficacy) of conventional treatments.  In fact, the increased use of steroidal drugs in the treatment of asthma patients has led to a variety of other chronic illness and to increased mortality (previously, very few people died from asthma, but that has changed as the drugs being used to treat it have increased in their immunosuppressive effects).  There are risks in everything we do (or don't do). [[User:Dana Ullman|Dana Ullman]] 01:31, 28 October 2008 (UTC)
:"Recent research has shown that some conventional drugs, which are normally used to do something, can do the opposite also - a rebound effect, similar to homeopathy's law of similars.<ref>{{cite journal |author=Kales A, Scharf MB, Kales JD |title=Rebound insomnia: a new clinical syndrome |journal=Science (journal) |volume=201 |issue=4360 |pages=1039–41 |year=1978 |month=September |pmid=684426 |doi= |url=}}</ref><ref>{{cite journal |author=Kirkwood CK |title=Management of insomnia |journal=J Am Pharm Assoc (Wash) |volume=39 |issue=5 |pages=688–96; quiz 713–4 |year=1999 |pmid=10533351 |doi= |url=}}</ref>
<ref>{{cite journal |author=Tsutsui S |title=A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia |journal=J. Int. Med. Res. |volume=29 |issue=3 |pages=163–77 |year=2001 |pmid=11471853 |doi= |url=http://openurl.ingenta.com/content/nlm?genre=article&issn=0300-0605&volume=29&issue=3&spage=163&aulast=Tsutsui |last2=Zolipidem Study |first2=Group}}</ref><ref>{{cite journal |author=Hohagen F, Rink K, Käppler C, ''et al.'' |title=Prevalence and treatment of insomnia in general practice. A longitudinal study |journal=Eur Arch Psychiatry Clin Neurosci |volume=242 |issue=6 |pages=329–36 |year=1993 |pmid=8323982 |doi= 10.1007/BF02190245|url=}}</ref>.
<ref>{{cite book | last = Reber | first = Arthur S. | authorlink = | coauthors = Reber, Emily S. | title = Dictionary of Psychology | publisher = Penguin Reference | date = 2001 | location = | pages = | url = | doi = | id = | isbn = 0-140-51451-1}}</ref><ref>{{cite journal |author=Kales A, Soldatos CR, Bixler EO, Kales JD |title=Early morning insomnia with rapidly eliminated benzodiazepines |journal=Science (journal) |volume=220 |issue=4592 |pages=95–7 |year=1983 |month=April |pmid=6131538 |doi= |url=}}</ref>
<ref>{{cite journal |author=Lee A, Lader M |title=Tolerance and rebound during and after short-term administration of quazepam, triazolam and placebo to healthy human volunteers |journal=Int Clin Psychopharmacol |volume=3 |issue=1 |pages=31–47 |year=1988 |month=January |pmid=2895786 |doi= 10.1097/00004850-198801000-00002|url=}}</ref><ref>{{cite journal |author=Kales A |title=Quazepam: hypnotic efficacy and side effects |journal=Pharmacotherapy |volume=10 |issue=1 |pages=1–10; discussion 10–2 |year=1990 |pmid=1969151 |doi= |url=}}</ref>.
<ref>{{cite journal |author=Hilbert JM, Battista D |title=Quazepam and flurazepam: differential pharmacokinetic and pharmacodynamic characteristics |journal=J Clin Psychiatry |volume=52 Suppl |issue= |pages=21–6 |year=1991 |month=September |pmid=1680120 |doi= |url=}}</ref><ref>{{cite journal| journal =Pharmacopsychiatry | year =1989 | month =May | volume =22| issue =3| pages =115–9| title =Can a rapidly-eliminated hypnotic cause daytime anxiety? | author =Adam K | coauthors =Oswald I| pmid =2748714| doi =10.1055/s-2007-1014592}}</ref>"


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


I see that a lot of 'negative statements' are being included in this article. If one keeps inserting all the allegations/criticism one can find on the Net, the credibility of Citizendium will be lost.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:40, 25 October 2008 (UTC)
Second, it's a leap to equate a rebound phenomenon to allopathy; the dose-over-time, molecular control mechanisms, etc., are much more than "opposites". One of the classic examples of rebound, nasally applied vasoconstrictors, doesn't take place when the dose and duration are properly controlled. In general, if the vasoconstrictor is needed for long enough to cause rebound, use of antiinflammatories, such as corticosteroids, cromolyns, or antihistamines should be under active consideration to replace the  direct vasoconstrictor.
:Without specific examples it is hard to comment. [[User:Chris Day|Chris Day]] 03:50, 25 October 2008 (UTC)


:::I have to agree with Chris, Ramanand.  It does not advance the conversation just to point out that there are a lot of "negative statements" in the article.  Could you elaborate?  Perhaps try to quantify or otherwise characterize "too many"?  Give examples of statements that you think go over the top, somehow?  Obviously, we do not want to give the impression that CZ takes an editorial stance ''against'' homeopathy; a reasonable, uninvolved reader should get the impression that we are neutral. --[[User:Larry Sanger|Larry Sanger]] 02:45, 26 October 2008 (UTC)
It was with considerable restraint that I didn't immediately move this to the talk page. Ironically, there are very pleasant, collaborative discussions going on in a number of military and history articles.  Maybe getting to kill people makes for more restrained discussion. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:04, 5 September 2010 (UTC)


::Rather than start a new section, I reverted out the addition of "although it is practised worldwide.", with the edit comment "the survey says it".
:The rebound effect is well documented and accepted in medical circles, so please don't delete that sentence or the refs I inserted (I've improved on the way it used to read, so pls take a look).—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:31, 6 September 2010 (UTC)


::First, the survey does not say it. The survey speaks of homeopathy in a list of countries, a list far smaller than the number of countries in the world. Second, I see no information added by the survey. Third, the survey itself is non-notable; the survey firm has 600-odd occurrences on a Google search; its website has no indication of any qualifications in health matters; the survey itself is written as an advertisement and does not give any methodological information -- but phone numbers to call if you want the company's services.  
::Well documented? "Rebound effect' doesn't appear in the index of the standard textbook, ''Goodman and Gilman's The Pharmacologic Basis of Therapeutics (9th Edition)''. Now, as I have mentioned, the term "rebound" is indeed used in very specific contexts, such as the response of nasal mucosa to topical vasoconstrictors.  


::I think the process in place can give the appropriate credibility for CZ.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:19, 25 October 2008 (UTC)
::"can lead to the opposite effect, when stopped - a rebound effect, which means they are following homeopathy's law of similars." is not especially an improvement. Of course there are drugs that have adverse effects when stopped inappropriately. Corticosteroids, selective neurotransmitter uptake inhibitors and opioids all come to mind. "Similars" have nothing to do with it, in the sense that a corticosteroid, in a Proving, would be inflammatory.  Instead, the adrenal cortex has reduced its production of endogenous steroids because it has sensed a certain blood level.


== Some thoughts on compromise ==
::It's vaguely amusing to hear you comment about people ignorant of homeopathy, when there seem to be so many opportunities to be unaware of molecular pharmacology. But, there are different tastes -- where's the eye of newt and blood of bat when you need them? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:18, 7 September 2010 (UTC)


At the end of the section on the ''Lancet'' controversy, I tried to flow into some thoughts that arose from a recent paper on external and internal validation in conventional surgery. I freely admit it's near my bedtime, and perhaps I should have put this all on the talk page, but I felt it really flowed from comments in the text, and perhaps complemented them.
==Dead link==
http://www.medscape.com/viewarticle/511604  Reference 102 about the value of talking to patients. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:08, 5 September 2010 (UTC)


Perhaps we are approaching some of this in the wrong way. While I still contend the statistical trial method that has been mentioned for [[pharmacogenetics]] could well work for prospective randomized controlled trials of homeopathic remedies, presumably versus a drug control group, there may be another model from evidence-based medicine. It's often not realized that surgical procedures do not need the approval that is required for drugs and medical devices. There is something in common between surgery and homeopathy: it is the profession that decides if a technique is effective.
:Then I suggest we remove the sentence attributed to Vandenbroucke.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:56, 6 September 2010 (UTC)


The difference I see, however, in the approaches of surgeons and homeopaths are that surgeons are not necessarily hostile to attempts to get more statistical rigor into after-the-fact review. The personal, subjective impression of Howard C. Berkowitz is that the homeopaths here, and in citations, seem utterly appalled by the idea that anyone might suggest that any two patients are treated in a compatible manner -- yet there are over-the-counter homeopathic remedies, and there are at least some relatively widely used remedies such as Oscillococcinum. Some homeopaths say that remedies can be preventive, while others deny it, and I must confess that cannot, as Chris put it, wrap my mind around the idea that if symptoms are required to select a remedy, prevention is done before symptoms occur, than how could a simillium be selected?
==Thankless CZ==
Editing CZ is a thankless job. I'm sure the people who are ignorant about a subject (like Homeopathy) can move on to Facebook, Orkut, Linked in, Twitter or some other networking site/s and make a lot of friends and get to know them really well - we hardly know anything about each other here. Howard, you're probably a nice guy I can get to know better and probably dine with. Sandy, Im sure I can make an interesting 'date'. Why don't y'all look for me on Facebook?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:56, 6 September 2010 (UTC)
:I have nothing against friendship, and I do think I've found a number of good friends here. Nevertheless, the essence of what I see as appropriate writing at CZ depends on courtesy, but above all, logic -- western if you will -- and evidence. I have a LinkedIn account, but not Facebook, Twitter, etc. -- and don't want them. On the other hand, I am very active on an assortment of professional mailing lists. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:50, 6 September 2010 (UTC)


Anyway, I hope there might be some constructive observations here. It doesn't prove or disprove homeopathy, but I think it gives me insight into why homeopathic and evidence-based medicine people can't seem to communicate. Where alternative medicine has become complementary, it always required both disciplines agreeing on some things. When I read things like miasms, even in the newer discussions I searched, I don't know where to start, and I read so much anti-medicine anger in some of those articles I sense little interest in trying to find common thinking. Can that be fixed?
:: First off, I greatly doubt either of us would enjoy a date. 'Sandy' is a short form of 'Alexander', and I'm neither unattached nor gay.
:: Second, some of your other apparent assumptions are just as bogus. People generally aren't here for social networking, but to contribute toward building an encyclopedia. Nor does not being an expert on homeopathy preclude contributing.
:: I'm resisting the urge to write a more pointed reply because it would violate [[CZ:Professionalism#What_behaviors_are_unprofessional.3F]]. [[User:Sandy Harris|Sandy Harris]] 23:47, 6 September 2010 (UTC)


I might suggest something that would help in this article: move the things 50-200 years old to the history article, other than a brief historical note. No modern physician will argue that the "mainstream" physicians of Hahnemann's day were totally incompetent by current standards. The problem, in my mind, is that there's little homeopathic recognition that medicine has learned by its errors. Pardon me, but homeopathy seems largely stuck in Hahnemann's model -- if there has been progress and reinterpretation, will some homeopath please, please discuss it in terms that a biomedical scientist can understand? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 05:39, 25 October 2008 (UTC)
==Confusing deletions==
It's somewhat difficult to tell why things are deleted when the only reasons given are in edit notes, which aren't always easily accessible if, for example, minor edits follow them in the log.


:Howard, I am strongly against moving historical information out of this article. Please know that conventional docs have asserted that their methods have been "proven" for 150+ years, and homeopaths have consistently questioned that statement and have been consistently accurate. We rarely doubt that conventional drugs "work," that is, they do temporarily remove symptoms, but is it just a coincidence that few drugs have won the test of time (admittedly, with rare exception).  
This was deleted, possibly due a claim that it was unsourced -- yet it is sourced. It's a reasonable statement and belongs in the article. <blockquote>This does not mean that that people treated with homeopathy do feel better as a result - the clinical literature clearly shows this, but Vandenbroucke suggested that this could be because its practitioners treatments spend more time with people than doctors do. "Even if people give you the wrong explanation about what you seek treatment for, the fact that they spend a long time speaking with you might help," Vandenbroucke suggests.<ref>[http://www.medscape.com/viewarticle/511604 medscape]</ref></blockquote>


:Based on what you've written here and elsewhere in this Talk page, it would seem that you would support a statement in every article on every surgical procedure that there have not been double-blind and placebo controlled trials that have "scientifically" tested this procedure. The bottomline is the good research needs to have internal and external validity, and it is THIS problem that homeopaths question.  It is akin to giving every conventional medicine patient antibiotics and then say that this "proves" that antibiotics don't work.  
"Homeopaths contend that flawed trials cannot be used to show that homeopathic treatment is ineffective <u>(please read the previous paragraph for information about the positive trials)</u>."  This new sentence, especially the underlined words, is argumentative rather than informative.  --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:50, 6 September 2010 (UTC)</i>


:Homeopaths are not against evidence based medicine.  Homeopathy has withstood the test of time and has done so internationally.  
:I didn't do the above editing, though I support it.  Just because Vandenbroucke says that statement does not mean it is true, especially when there is at present no data to support it.  This idea borders on the preposterous that the "extra" time that homeopaths spend with their patients leads to the therapeutic benefits that homeopathic patients experience.  If THAT were the case, then, psychologists would be our finest healers (and sadly, they are not).  Although the first interview with a homeopath is typically an hour, the follow-up visits are usually 10-30 minutes, just a little longer than a conventional MD.


:Howard, a good resource to you is the writings on Paulo Bellavite, MD, a professor of pathology, whose work is available online, though his book, "The Emerging Science of Homeopathy," is also worthy.  [[User:Dana Ullman|Dana Ullman]] 15:08, 25 October 2008 (UTC)
:As for "flawed" trials, see my longer message in the next section where I talk about the importance of "internal validity" in trials AND "external validity." [[User:Dana Ullman|Dana Ullman]] 01:09, 14 September 2010 (UTC)


::First, a note on terminology. "Placebo-controlled" is not synonymous with [[randomized controlled trial]]. The current World Medical Organization interpretation of the Declaration of Helsinki considers placebo controls generally to be unethical in the absence of established treatment.
==Dana Ullman's thoughts on this article to date==


::I would support a statement, on surgical procedures when blinding is not possible, that they have not undergone the testing or review that are applied to drugs or what the FDA defines as medical devices. I would not support such a statement for drug or device therapy.
Sorry to be away from the article for so long...


::I don't understand your point about giving every conventional medicine patient antibiotics. Antibiotic therapy and resistance has been a research interest of mine for over 40 years. If you can show me that homeopaths use as rigorous a method as a competent physician uses to prescribe antibiotics -- empirical therapy based on local infection control information when the pathogen and sensitivity are obvious without microbiological lab support; culture, sensitivity, immunoassay, and even bacterial genetic analysis when the diagnosis is in question -- I will be very interested.
I am very concerned about this present “draft” of the homeopathy article. I feel that it has lost its “encyclopedic” tone, and instead, it is a mixture of encyclopedic information along with strong “point of view” skepticism. Although I do not have a problem with proper skepticism, it is the tone of it AND where it is placed in the article that is critical.


::Conventional docs now recognize when they were wrong for 150 years. The theory and techniques are radically different. There is constant review and improvement. If you want to argue from 1810, 1905, or even 1955, I feel it appropriate to note that EBM rejects the therapies of those times. I do note very little mention of review and improvement in homeopathy, but an enormous amount of anger, and some of that going back literally hundreds of years.
For instance, in the very top portion of this article are paragraphs #3 and #4 which are not encyclopedic in tone or content.


::You are mixing apples and spinach to jump from surgical to pharmacological testing. I would point out that I cited surgeons' concern with validation and how they might improve.  
I will try to avoid doing “editing” the article myself.  Instead, I will propose here in the TALK section my ideas for what should be said, and I hope that those people who want to maintain a high-quality objective and encyclopedic article will make appropriate changes to the Draft. Needless to say, I will not sign my name, as a Healing Arts Editor, to anything that does not maintain a certain objective tone.  And by “objective tone,” I obviously do not mean that this article should just a promo for homeopathy.


::In all sincerity, I would ask you to look at parts of this article, putting yourself in the position of the hypothetical healer from Mars would look at its words and infer that homeopaths are not against evidence-based medicine. Part of my appeal last night was to tone down some of the hostility.  I rewrote some of complaints by homeopaths about trials, when I read the actual papers and found they attacked homeopathy far less than the article text suggested. I'd like to see some of the same humility and knowledge that they need to improve that ethical physicians use, not "Homeopathy has withstood the test of time and has done so internationally." The impression this article gives is that homeopaths have largely taken Hahnemann's model and, at best, made minor tweaks. If that is wrong, make it clear, and one of the first ways to do so is to put out examples of where homeopaths have discarded methods. It's not my job to go out and research that homeopathy has done it -- my job here is to represent the view of someone that believes that constant review and process improvement is the standard of conventional medicine, and physicians have developed a lot more humility since 1810. They have taken positive steps to continue improving. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:02, 25 October 2008 (UTC)
:My sincere thanx for whoever re-formating my contribution so that we can communicate about them in bit-sizeable chunks. Good work!  [[User:Dana Ullman|Dana Ullman]] 15:37, 14 September 2010 (UTC)


:::Howard, homeopathy has evolved every year since it started, and every year we add new medicine and new insights about healing.  Today, the vast majority of homeopaths use expert system software to help them find the indicated medicine for the sick person with greater precision.  However, when homeopaths add new medicines, they don't have to throw out the old because the old still work for the syndrome of symptoms that they are known to cause.  They have also developed different methods to find the correct method (besides software).  While there IS constant evolution of homeopathy, the strength and stability of homeopathy is that the new information is in addition to the old, not in replacement of it.   
=== Dana on 3rd paragraph===
Ultimately, I recommend some changes in the 3rd paragraph…here’s what I suggest for replacement for this paragraph.   


:::Howard, you wrote, "Conventional docs now recognize when they were wrong for 150 years."  It is easy to admit errors in the past.  It is more difficult to admit them in the present. One can get rid of pain with various drugs and call that "evidence based medicine," and yet, inevitably, future Howards and others will admit that they were wrong in the past but insist that they are "right" now.  Sad ole story.  No anger here, just the fact 'mam.
::While many medical practitioners prescribe some homeopathic remedies, a significant majority of the scientific and conventional medical community (including a number of national medical representative bodies like the British Medical Association), consider homeopathy to be unfounded and pseudoscientific.[1] Skeptics of homeopathy insist that there is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. However, homeopaths and scientists from varied specialties, including Nobel Prize winning virologist Luc Montagnier, assert that there are viable theories about how homeopathic medicines may act, though as yet, no one explanation has been verified.  Advocates assert that the homeopathic “principle of similars” is, in part, the basis for modern day immunizations, allergy treatments, and select other conventional treatments (ie, the use of Ritalin and other amphetamine-like drugs used to treat hyperactive children), while critics have compared it to sympathetic magic.


:::Historically, homeopaths are considered "empiricists" while conventional docs considered "rationalists."  Conventional medicine is rational, while homeopaths use what works. Howard says that physicians have "developed a lot more humlity since 1810."  Huh?  As you might say, show me the evidence.  [[User:Dana Ullman|Dana Ullman]] 13:24, 26 October 2008 (UTC)
::: I wrote the current text. To me it seems accurate and encyclopedic, much better than either what it replaced or your suggestion.


:::"future Howards and others will admit that they were wrong in the past but insist that they are "right" now" Again, the rules of CZ are not about personal judgments.
::: My "While the founder of modern homeopathy was a medical doctor, some modern medical practitioners do prescribe some homeopathic remedies, and some governments do recognise homeopathy as legitimate treatment" instead of your "While many medical practitioners prescribe some homeopathic remedies" gives more arguments favorable to homeopathy, but states them more carefully, your "many" seems dubious to me.


:::Let's see. Physics, chemistry, farming, construction, mathematics, biology, ethics, law, land transportation, warfare,  sea transportation, air transportation (well, we still have hot-air balloons, but they've changed), mining, social services, clothing, and other things, have largely thrown away 1810 practice, not added to it (well, maybe not law). The means we are using to have this conversation was inconceivable in 1810. Even in the performing arts, while we certainly use compositions and plays that existed well before 1810, the actual presentation makes them available for immensely larger populations. Only homeopathy, it would seem, had the only true body of knowledge from the beginning, needing minor improvements, and, for some reason, it has not become a consensus of mankind.  
::: My "the consensus of medical and scientific opinion is that homeopathy is unfounded." seems to me a simple statement of fact.


:::Larry, I believe you were saying something about offering compromise? I'm beginning to think, for example, some documentation about the change in repertory and materia medica since 1810, in comparison with the amount of change in virtually any form of human knowledge. To use something indeed ancient, ''res ipsa loquitur'', and, for that matter, ''sic transit gloria mundi." [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:26, 26 October 2008 (UTC)
::: I removed the claim that it is "pseudoscientific", which seems to me true but unnecessary here. Criticism is fine; gratuitous insults are not.


Hmmm, I hope that everyone can see why some pro-homeopathy show some anger here. I wonder if you would say the same things about acupuncture or herbal medicine. I wonder what you'd write about gravity:  it can't be right because it has been around for such a long time, and it hasn't "evolved" enough as compared with other fields. You're on the edge of the ridiculous. By the way, there is one homeopathic software program called RADAR that has been around for around 15 years, and it is in its 10th edition because they continue to update its body of information (materia medica and repertory). The core information is the same in homeopathy, but there has been tremendous development in the field just in the past 15 years.  Howard, you're not just wrong, you seem to revel in your anti-homeopathy bias. Please do more homework and consider more humility.  That said, it is a tad ironic that you just recently wrote that today's physicians have so much more humility than physicians in the past.  Yeah, right. [[User:Dana Ullman|Dana Ullman]] 22:08, 26 October 2008 (UTC)
::: I do not think the British Medical Association or your "However, ..." or "Advocates assert ..." belong in the lede. The lede needs to be a simple summary of key points. The BMA, Montaignier and Ritalin might all be discussed later, but they do not belong here. [[User:Sandy Harris|Sandy Harris]] 03:34, 14 September 2010 (UTC)


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


I asked above who added in the "42% of British doctors refer to homeopaths" statistic, and nobody volunteered the information. So I actually had to go through the history and [http://en.citizendium.org/wiki?title=Homeopathy&diff=100392675&oldid=100392599 find it myself]--something I'm not particularly happy about having to do.  If we're all working on this article together, we should be forthcoming about such information.
:: It depends on the interpretation of the word "plausible". Certainly there are explanations, but I'd say none are plausible. [[User:Sandy Harris|Sandy Harris]] 02:31, 15 September 2010 (UTC)


I would again like to request an explanation for Dana as to the error of the source.  I imagine it was just carelessness? The reason I think it is important to ask is, I would like to know ''how much more'' of the references we need to check, in order to correct some really egregious and potentially embarrassing errors. Such an error can reflect poorly on ''all'' of us who are working on this article. If it was carelessness, I'm afraid that means we should carefully check every single one of the many footnotes Dana has entered.
: Sandy suggests above that my reference to "many physicians" prescribing homeopathic medicines "seems dubious." Perhaps it would help if he re-read our article here where in the "Homeopathy in Practice" section gives some specific figures: "In Europe homeopathy is practiced by many conventional physicians, including 30-40% of French doctors and 20% of German doctors. Some homeopathic treatment is partly covered by some European public health services, including in France and Denmark. In France, 35% of the costs of homeopathic medicine prescribed by a medical doctor are reimbursed from health insurance."...Clearly, the term "many" is not dubious.  [[User:Dana Ullman|Dana Ullman]] 15:48, 14 September 2010 (UTC)


Anyway, everyone, please do be careful about your claims about what your sources say, and how you characterize the research they contain. --[[User:Larry Sanger|Larry Sanger]] 03:01, 26 October 2008 (UTC)
:: See the discussion under "unsupported assertions" above. Those claims do belong somewhere in the article, if they can be supported, but the lede as it stands seems to me a good summary. [[User:Sandy Harris|Sandy Harris]] 23:21, 14 September 2010 (UTC)


:Larry, I mistakenly thought that the BMJ article on "Complementary Medicine in Europe" had the above statistic, but I corrected it above with the more exact reference.  The bottomline is the information was correct, and the only problem is that an additional reference needed to be added.  Thanx for encouraging precision.  [[User:Dana Ullman|Dana Ullman]] 13:05, 26 October 2008 (UTC)
: I have a question for Sandy and Howard and other skeptics.  At present, in this lede, there is the sentence:  "To a skeptic, the 'principle of similars' is merely an appeal to sympathetic magic." Out of curiosity, do you believe that there is a certain wisdom of the body?  Do you believe that the human organism tries to adapt to infection and/or stress by creating symptoms in order to survive?  If you answer YES or MAYBE to EITHER of these questions, then using drugs that mimic the body's defenses make sense, and as such, we HAVE to delete or change this ill-founded sentence.  Please also remember that the "high potencies" is only a part of homeopathy and that most homeopathic medicines sold in health food stores and pharmacies today are in small, material doses.  It is inappropriate (and inaccurate) to assume that ALL homeopathic medicines are in doses beyond Avogadro's number.  [[User:Dana Ullman|Dana Ullman]] 16:34, 14 September 2010 (UTC)


== Prevalence of health care provider types ==
:: That sentence is fine. What we believe is not at issue. The paragraph is trying to summarise the position about homeopathy of skeptics and critics. I'd say that, if anything, it understates their revulsion. Granted, other parts of the article should give a much more favorable view, but the negative views should be there as well. [[User:Sandy Harris|Sandy Harris]] 23:21, 14 September 2010 (UTC)


The article now states, with no sourcing,  
:::Individual belief is outside the scope of the article, but no, I don't think there is a "wisdom of the body", and, using the medical definition of [[symptom (medical)|symptom]], the body doesn't create any symptoms -- the mind does. Symptoms are subjective, and signs are objective. A sign may be evidence of a defense mechanism, but it's far more likely to be evidence of a disease process.
<blockquote>There are estimated to be more than 100,000 practitioners worldwide, and 500 million people receiving homeopathic treatment, making it the most popular system of medicine after conventional medicine.</blockquote>


Hmmm...so, 5000 patients per homeopath, if equally divided? Pretty good workload, given the lengthy visit times reported in the article. I note that the visit times also aren't sourced.
:::The great fallacy I see here is the assumption that proving-based drug mimic the actual defenses. The body's direct defenses against ''[[Clostridium tetani]]'' exotoxin in [[tetanus]] are immunologic. Those defenses are supported by administering synthetic tetanus immune globulin -- we learned to avoid the horse serum preparation as too risky -- to give initial passive immunity, and tetanus toxoid to build active immunity. These don't "mimic" the defenses; they '''are'''  the defenses. The body really doesn't have defenses against the neurologic effects of the toxin, but benzodiazepines, neuromuscular blocking agents, baclofen and dantrolene provide what, I suppose, could be called "symptomatic" relief. Without getting into all the receptors, we have a pretty decent idea '''how''' these drugs reduce the spasticity; we don't need to go the route of finding similars.  


While I recognize that there are varying levels of homeopaths, and some people are qualified in homeopathy and conventional medicine, let's discuss a little perspective on this number, and see if it really belongs in the article. Going to the UN/WHO health statistics database at http://data.un.org/Data.aspx?d=WHO&f=inID%3AHSR01, I didn't find a worldwide total, and it doesn't easily copy into a spreadsheet. So, as a first approximation, the countries with more than 100,000 physicians are;
:::I'm not opposed to using unusual explanations when there are no better ones. "Wisdom of the body" sounds like something for a Religion Editor. I do use complementary methods when I have some reason to believe in a favorable risk-benefit. As soon as I hear that something is risk free, alarm bells go off. There are always tradeoffs. I'm facing a terrible one now, as the American Veterinary Medical Association described euthanasia as a means of comfort care that has the side effect of death -- yet I have a beloved cat who has a greater will to live than any human I've ever encountered. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:56, 14 September 2010 (UTC)


Argentina, Brazil, China, Egypt, France, Germany, India, Italy, Japan, Mexico, Pakistan, Russian Federation, Turkey, UK, Ukraine, US.
The text you are questioning is "There is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. To a skeptic, the "principle of similars" is merely an appeal to sympathetic magic." I think that is OK as it stands.


So, conventional medicine is sufficiently popular that 16 countries each have more physicians than there are homeopaths in the world. Now, in excess of 200,000, the US has 730,801, Russia has 614,183, Italy: 215,000, Japan: 270,371, India: 645,825, France: 207,277, China 1,862,630.  Not feeling like doing a lot of computation, let's just round these down and subtract 100,000. That gives 37 extra WorldNumberOfHomeopaths.  37 + the original 16 makes the homeopath to physician ratio 53:1.
It could be replaced with something that both states the skeptical position better and mentions that not everyone is skeptical:


Is that a dominant force? During the Cold War, there was an auto race in Moscow, with a Corvette against a Zil. ''Pravda'' reported that the Zil won second place, while the American car could do no better than next to last.
: To a skeptic, there is neither any solid evidence that homeopathy is effective nor any plausible explanation of why it should be, and the "principle of similars" is merely an appeal to sympathetic magic. Homeopaths, however, believe that they have good answers to these criticisms.


I suggest that either these numbers and "popularity" statements come out, or CZ require they be fully sourced. Remember, that means that it's only fair to have a list of celebrities that use conventional medicine.
::Close.  Let me urge that [[sympathetic magic]] show as a wikilink, as it is not just a throwaway pejorative, but an anthropological term that shows up across many cultures. Consider dropping the "merely". When I wrote the article on sympathetic magic, it wasn't intended to disparage, but to explain a cultural pattern.


If necessary, I'll figure out how to add up the UN numbers. Of course, those will be sourced, so it would only be fair that the homeopath numbers be sourced. Shall we do that? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:09, 26 October 2008 (UTC)
::Is it necessary to bring up both the Avogadro argument ''and'' similars in the lede, purely from a standpoint of complexity?  Yes, I understand that potentiation is an argument that can be countered with the Avogadro point, but similars seem more basic than potentiation in understanding the core argument of homeopathy.


===External validity of the homeopathic patient loads===
::I am ''not'' trying to be argumentative when I say that arguing that the principle of similars is an equivalent or superior explanation, to a drug that was designed using molecular structure-activity relationships, is inflammatory. It's one thing for the homeopaths to say why their own preparations work, but it's pushing too hard to say that the homeopaths have better explanations for the drugs developed under different paradigms. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:46, 15 September 2010 (UTC)
The article says "Generally, a typical homeopathic interview can last from 15 minutes to two hours, with 5 to 45 minute follow-up consultations." If I use an average of 45 minutes, that means 3750 hours per homeopath per year, to see each patient once. A 40-hour work week provides 2080 work-hours per year, before holiday, sick time, or professional education are counted. To see that many patients once, it's a 93.75 hour week.


Are we really, really sure these are plausible numbers? I propose to delete them. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:48, 27 October 2008 (UTC)
=== 4th paragraph===
I believe that the present 4th paragraph has NO place in the top section.  Discussion of the “possible dangers” from the patient or the doctor’s decision to not use conventional treatments has NO place here. If others wish to insert this information under its proper section, I do not have a problem, though we must then acknowledge: Homeopaths respond to the possible dangers from using homeopathic medicines in replacement of conventional medical care by asserting that there are much greater dangers by using conventional medicines as a first method of treatment.


===Upon reflection===
: It probably needs mention of the fact that homeopaths retort that conventional medicines may also have large risks. I'm inclined to think it does belong in the lede, since these risks are a basic issue about homeopathy. However, I don't feel remarkably strongly about that and would be interested in hearing other opinions. [[User:Sandy Harris|Sandy Harris]] 03:44, 14 September 2010 (UTC)
I have moved to this talk page the footnote, formerly in the body of text,  


"These include some transcendentalists ([[Goethe]], [[Alfred Tennyson]], [[George Bernard Shaw]]), politicians (including 11 U.S. Presidents, two British Prime Ministers, [[Mahatma Gandhi]], [[San Martin]] and numerous other world leaders), corporate leaders ([[John D. Rockefeller]], [[Charles Kettering]]), clergy and spiritual leaders (seven popes and dozens of Eastern spiritual teachers), sports stars ([[David Beckham]], [[Martina Navratilova]], [[Boris Becker]]), musicians ([[Ludwig van Beethoven]], [[Frederick Chopin]], [[Tina Turner]], [[Cher]]), artists ([[Vincent van Gogh]], [[Camille Pissorro]]), and many other cultural icons.  [[Charles Darwin]] is known to have taken homeopathic remedies, [[William Osler|Sir William Osler]] greatly admired Hahnemann, [[Charles Frederick Menninger]] first trained as a homeopath, and [[C. Everett Koop]] was inspired as a child by the family homeopathic physician.  See [http://www.homeopathicrevolution.com/]."
::I would prefer to see it go unless the homeopaths present a statistical risk-benefit argument, based on modern medical practices, not 1900, that the hypothesis is true that the clinical outcome is better with homeopathic treatment than medical or no treatment. The risks of most medical treatments are quantifiable, as are the benefits, with the understanding that statistical aggregates do not apply to individuals.


If this is reasonable to include, surely it is appropriate and neutral to present, side-by-side, the various transcendentalists, politicians, corporate leaders, clergy and spiritual leaders, sports stars, musicials, etc., who are known to have taken mainstream medical treatment.  
::There are any number of times I've chosen something with significant risk, because there was reasonable evidence the risk was greater than the benefit. Obviously, a cardioplegia solution that stopped my beating heart was risky, but the risk of not having the open-heart surgery was greater.  There was reliable data for risk at each stage of the procedure.


There is also a bit of mixing of oranges and potatoes here, by switching from those to people who have, for a very wide range of reasons, admired or studied homeopathy or individuals who practiced homeopathy.
::When other children would chant "your mother wears army boots," I'd point out that they were part of her uniform. The "medical treatment is more dangerous", without substantial data, rings equally relevant to me. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:34, 14 September 2010 (UTC)


I must inquire about the appearance of conflict of interest. The only source given here is www.homeopathicrevolution.com, with no other information about its source. The first lines on that page, however, are <blockquote>The Homeopathic Revolution:
::: "I would prefer to see it go unless ..." is not clear to me. Are you saying that text on homeopathic rejoinders should not be inserted, or that we should follow Dana's suggestion and remove the current 4th paragraph from the lede? [[User:Sandy Harris|Sandy Harris]] 05:30, 14 September 2010 (UTC)
Famous People and Cultural Heroes Who Chose Homeopathy
— a NEW book by Dana Ullman, MPH</blockquote>  When I have cited my own (peer-reviewed) publications, I have always made a point to fully identify the source in the citation, and make a personal practice of making a disclaimer on the talk page of the relevant article. What are the CZ rules for situations such as this? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:40, 26 October 2008 (UTC)


:Personally i find this information adds nothing to the article. I have said this before in now archived sections of the talk page.  First, Dana wanted this in the introduction without it even being in the body of the article. I tried to move it to the popularity section as a compromise, this was not popular. I then tried to reduce it to a footnote as it seems more appropriate given it adds little to our understanding of homeopathy.  That seemed like a fairly obvious compromise but I do agree it could be cut completely and no harm the article.  Actually, it would make the article stronger, in my opinion. I will give a clear rationale for this opinion if needed. [[User:Chris Day|Chris Day]] 17:02, 26 October 2008 (UTC)
::::Unless the homeopathic rejoinder has strong statistical support, it should not be in the article. It's one thing if there is a formal risk-benefit analysis proving a hypothesis, but if it's no more than "well, medical treatments are dangerous," it's irrelevant defense. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 06:25, 14 September 2010 (UTC)


::For the record, I did not place the above information in the article, though I do think that it has a place in this article. There are MANY academic books by medical historians who note that the users and advocates of homeopathic medicine in the 19th century were the cultural elite:  the leading literary greats, the wealthy classes, the royalty, the clergy, and musical greats. It is true that my book is presently the best reference to ALL of them, while other sources are good for each group. Previously, the introduction to this article made reference to the British royals' support for homeopathy, and it seemed to me that this was the best place for adding further information about other leading supporters.
In due respect, the formal risk-benefit analysis needs to go BOTH ways.  What evidence do you have for the "dangers" of receiving homeopathic treatment...and please do not give individual cases. I do have access to numerous cost-effectiveness studies showing significant cost savings to people who utilize homeopathic medicines. [[User:Dana Ullman|Dana Ullman]] 15:34, 14 September 2010 (UTC)


::Howard's desire to list all of the "other" famous people who used conventional medicine is more than a tad silly, though he is welcome to do so in the article about conventional medicine, not THIS article (IMO). [[User:Dana Ullman|Dana Ullman]] 22:24, 26 October 2008 (UTC)
:Bluntly, it does not need to go both ways. Homeopathy is desperately trying to claim a place at the table in the face of enormous evidence that molecular medicine is effective. It seems your position is that homeopathy and medicine are of equal status and that every claim against homeopathy must be counterattacked by one about medicine.  If, indeed, homeopathy is so much an alternative to medicine, this is useless.


:::Dana, I would be much more open to that list of names being in the [[history of homeopathy]] article, which is more the place for social context. Otherwise, its presence, without a list of people who have remained quite comfortable with conventional medicine, seems a rather contrived way of increasing the social impact of homeopathy.
:Incidentally, it would be wise for you to identify your financial interests in the promotion of homeopathy, such as (from http://www.homeopathic.com/main/bio_dana.jsp):
:*Dana Ullman, M.P.H. (Masters in Public Health, U.C. Berkeley) is "homeopathic.com" and is widely recognized as the foremost spokesperson for homeopathic medicine in the U.S.
:*Dana founded Homeopathic Educational Services, America's largest publisher and distributor of homeopathic books, tapes, software, and medicine kits. For 10 years he served as formulator and spokesperson for a line of homeopathic medicine manufactured by Nature's Way, one of America's leading natural products companies.


:::For the record, I find that celebrity endorsements, much less mention that celebrities may, at some point, had something nice to say about some subject, has little place in an encyclopedia article about any subject. Now, if C. Everett Koop had actually endorsed homeopathy, that would be very significant. Since, however, the quote from his biography said that he admired one homeopathic physician as a boy in the 1920s, there are zero MEDLINE hits on Koop and homeopathy, and his 13-page curriculum vitae at Dartmouth Medical School does not contain the word "homeopathy", there is no reason to believe that he supports the discipline. Koop has never been shy about making his position clear.
:See Bob Badgett's developing article on [[conflict of interest]]. It is one thing for a practitioner to charge for professional services, but it is generally considered unethical for physicians to refer patients to testing facilities, publications, etc., from which they derive income.  


:::I will bring up again that there is no sourcing for the unsourced figure of 100,000 homeopaths, 500 million patients, and it being the second most popular form of healing in the world. Unless someone can source that material, my preference would be to remove it. Otherwise, since I believe Larry has made clear that the article is to be seither a marketing piece for homeopathy nor an all-out attack on it, I shall add the equivalent numbers for conventional physicians, which places homeopathy in demographic perspective. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:07, 26 October 2008 (UTC)
:You are the one making the claims that medicine is so dangerous. I didn't make claims about ""dangers" of receiving homeopathic treatment", which is a change of subject. I will say, however, that it is dangerous to seek homeopathic treatment in lieu of medical treatments of established efficacy. Now, that seems a backing-off from the dangers of conventional medicine, but there seems a dearth of such studies from sources not vested in homeopathy. Again, these studies need to be overwhelming to dispute the CZ policy of providing the mainstream view.  


Dana you say "''For the record, I did not place the above information in the article,''" but in the  [http://en.citizendium.org/wiki?title=Homeopathy&diff=100392675&oldid=100392599 history link] Larry cites [[Talk:Homeopathy#Double-checking references|just above]] it appears that it is the very same edit where it was added. Your edit, straight into the introduction. Maybe that was not your intention since it was the same edit where you misreferenced the 42% figure? [[User:Chris Day|Chris Day]] 01:06, 27 October 2008 (UTC)
:"NPOV", incidentally, is WP-speak and discouraged here.  


:Chris, I meant to say that I did not provide the "reference" to my book to this article. Thanx for keeping me honest.
:Incidentally, apropos of being encyclopedic, how about contributions other than your single subject? Some of us are interested in building an encyclopedia, not fighting a never-ending battle with single-issue advocates or, as Sandy responded to Ramanand, social networking. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:48, 14 September 2010 (UTC)


:As for some of the prevalence info in this article, I remember reading in a WHO journal that there are over 100,000 homeopaths in India alone (I will try to find that reference).  In the meantime, I do not know any reliable figures for the overall number of people who use homeopathy today.  Let's delete the 500 million figure...and let's remove the information about homeopathy being the "second most popular form of healing in the world." Some homeopaths make this statement, but I know it is wrong.  Herbal medicine is used by many many more people.  [[User:Dana Ullman|Dana Ullman]] 13:23, 27 October 2008 (UTC) [[User:Dana Ullman|Dana Ullman]] 13:23, 27 October 2008 (UTC)
:: Wow, Howard, you're now getting disperate...and I'm sorry to see this.  First, for your information, I was personally asked by Larry Sanger (the founder of Citizendium) to edit here, and he asked me to become a Healing Arts Editor.  I have never hid any fact about my background.  In fact, most people appreciate my knowledge and expertise, except those few people who are threatened by facts, research, references to data, and the substantiation of information.   
::I see, I was referring to the content not the reference.  i have no problem with the reference.  I'm just not sure how we should use the material. As a note I found it to be appropriate, as a list in the article it seems out of place.  [[User:Chris Day|Chris Day]] 01:54, 28 October 2008 (UTC)


===A good example===
:: You and Sandy were asking me for "evidence" that conventional medicine has certain risks.  While I could have laughed at this seemingly innocent (or naive) request, I simply responded by asking you to provide evidence that there was danger to homeopathic treatment. Instead of providing this evidence, you have chosen a different strategy to get your bias into this article.  Let's avoid such tactics...and let's try to work together to write something fair, accurate, verifiable, and encyclopedic. [[User:Dana Ullman|Dana Ullman]] 22:26, 14 September 2010 (UTC)
Dana, I'm glad you brought up herbal medicine. There seems to be no CZ article on it, although I've been hunting through ''Medical Subject Headings''' and failing to find a good article title. "Phytotherapy" and "Herbal medicine" are defined in a mutually exclusive way, but not under a common term.


I mention this only briefly, but I wanted to point out that there seems to be much better communications, without absolute agreement, between herbalists and biomedical people. This is something I encounter frequently; one of my extended family considers herself an herbalist, and we have gone through some interesting discussions since she is one of the holders of my medical power of attorney. It's been possible for us to agree, "yes, I know you think highly of this particular herbal against cancer. Should I develop cancer and no other treatments are available, I do not want that herbal used. I want palliative care. At the same time, if I were acting for you and you were in the same position, I would respect your wishes and make it available."
:::No, I don't believe it is possible to collaborate with you to write something that is fair, accurate, and is not far more supportive of the benefits of homeopathy than is supportable by the views recognized by the bulk of medical opinion and data. I believe the best I can do is point out evasions, selective and often inaccurate statements about pharmacology, misquotations (e.g., saying Sandy or I asked for "evidence" medicine has risks), and what I believe to be a significant conflict of interest. I do so in discussion here, to be sure other members of the community see it, rather than jump into revert wars.


There is clear active research into plant-based medications, and refinement of the techniques.  There's no question that digitalis leaf preparations are ancient and potentially very effective, but the herbalists I know do not feel their art is contradicted because synthetic digoxin is used; they recognize the digitalis glycosides have so little margin between therapeutic and toxic levels that the predictability of synthesis, of a known herbal component, make sense. We can agree that there is abundant data showing that valerian can do comparably to benzodiazepines and the major reason it is not a therapeutic alternative in the U.S. is that there is no commercial incentive for drug approval.  
:::I have never suggested that medical treatment does not has risks; medical treatment ''always'' has risks. What I find to be hand-waving is the implication that homeopathy has no risks, including the delay of effective treatment.  


I can think of several areas of CAM where there is this sort of interaction and seeking of common approaches. Perhaps the problem is that homeopathy is fundamentally an "alternative" or "whole" system. One of the things that should be getting more attention, in this article, is the interaction between homeopath and patient. With no disrespect, even if homeopathic preparations are all placebo, I'm perfectly willing to say that some homeopathic interactions are beneficial. There are complex economic issues in physician time, but perhaps the model of how a homeopath interacts could be very useful for more affordable nurse practitioners or physician assistants, making the physician the powerful drug specialists.
:::You will note that I have asked for an Editor ruling on what I consider continued misues of von Behring as an authority that homeopathy works. I find it sad that regardless of what was done to design a treatment, the data-free argument that similars ''might'' be an explanation continues to be brought up.  


It's rather sad this sort of discussion is not emerging. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:24, 27 October 2008 (UTC)
:::Larry Sanger is not a health professional, and, I suspect, asked you to be a Healing Arts Editor because you are visible in that field. I would be much less antagonistic to your contributions were you to focus on what homeopaths believe and do, rather than the frequent -- and frequent inaccurate -- attacks on medicine, such as your condescending remark that there are no antifungal and antiviral agents of demonstrated efficacy, and, indeed, demonstrated risk. Indeed, the risk of unmodified amphotericin B has led to significant molecular work to reduce toxicity. You give the impression, however, that Hahnemann got it all right in the early 19th century, and medicine continues to get it wrong.


: Howard, Western herbology is primarily used in a similarly reductionistic and symptomatic fashion as conventional medicine, while Eastern herbology, as commonly practiced by acupuncturists, is much more systemic and constitutional and even based on the energetics of meridians.
:::Professional collaboration does not require that participants like one another. It does not help when they are patronizing, and, if they can't take focused criticism without changing the subject, perhaps the kitchen of knowledge is a bit too hot. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:53, 14 September 2010 (UTC)


: Andrew Weil commonly talks and writes about digitalis, and he notes that herbal doses of it create various digestive symptoms as side effects (i.e. nausea) of overdose BEFORE causing more serious cardiovascular side effects.  The synthetic version of digitoxin has little digestive side effects, while the side effects go directly to the heart, thereby creating much more danger than the herb.   
Howard, my concern about your editing is that you are just fabricating fights.  You wrote above that I said
"there are no antifungal and antiviral agents of demonstrated efficacy."  Where (!) did I say OR simply imply that?  Nowhere!  I even repeated my point that we all have to be careful in making broad statement such as the "collective weight of evidence".  THIS is what I mean by "straw men." You create arguments with yourself by making up what I say.   


: At this point, I both want to express my appreciation to and for you and to apologize for the many times that I have been patronizing to you.  You are really trying to understand things, and although we are both primarily working out of our own different worldviews and although we are still struggling to understand and respect each other, I wanted to stop for a minute and say that I want to try harder to communicate clearly with you. [[User:Dana Ullman|Dana Ullman]] 01:44, 28 October 2008 (UTC)
:Where did you imply that? In an unsigned entry following mine of    Howard C. Berkowitz 04:25, 14 September 2010 (UTC)
:''I am surprised and even a bit shocked to hear your assertion that antibiotics are effective for viral and fungal infections,''
:Obviously, I disagree, because I then listed numerous examples of antimicrobials effective against such infections.
:If you want to accuse me of starting fights with myself, I'll simply conclude that one of me will always win. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:38, 15 September 2010 (UTC)


::Thank you. We shall try.


::Regardless of what Dr. Weil may say about herbal doses of ''Digitalis purpurea'', I would not rely on nausea as a warning of toxicity from digitalis glycosides. Both digoxin, which does not occur in nature and digitoxin can be synthesized, but digoxin's half-life allows once-daily dosing. The class remains incredibly valuable, but has a very narrow margin between therapeutic and toxic levels. It's an excellent example of a drug with an extremely nonlinear dose-response curve, and a huge number of metabolic and pharmacologic interactions. Perhaps I'm conservative, but I prefer to see it started with hospitalized patients, or with access to frequent cardiac monitoring and blood levels. There was a time I had to take it for a specific short-term indication, and, from my first dose, I kept a close eye on the cardiac monitor (well, once I was conscious). It's a necessary part of the overall treatment of heart failure, but it is no longer the initial drug, but one you try not to need. Its toxicity is such that there was commercial justification to develop a specific neutralizing monoclonal antibody.
To clarify (again), my point is not that there are no risks to homeopathic treatment. However, IF we wish to highlight that there are certain risks to homeopathic treatment, we also have to acknowledge that it is widely recognized that there are much greater risks from conventional medical treatment. [[User:Dana Ullman|Dana Ullman]] 03:43, 15 September 2010 (UTC)


::Let me pose a thought experiment. Perhaps we might pick a chief complaint that is significantly defined by symptoms, [[fibromyalgia]]. There seems little question that the best medical success is with a team approach, and I wonder if there might be parallels between the interaction of team members with the patient, and the perhaps longer individual interaction with the homeopath. There are assorted medical situations where a nurse practitioner or even clinical pharamacologist, who interacts more directly with the patient than do many physicians, seem to get better results. At least in the U.S., economic factors prevent many physicians from having the interactions they believe is proper care. I know an endocrinologist, for example, who made more money and was much unhappier doing general internal medicine as well, under heavy time pressure. When he pulled out of the group and went into solo practice restricted to endocrinology, he spent the time with patients that he believed they needed, not what his business manager dictated. Since few U.S. plans reimburse homeopathic care, the business managers and third-party payors drop out of the practice of healing. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:39, 28 October 2008 (UTC)
: Certainly we should say somewhere in the article that there are also risks with other treatments, and that one of the arguments for homeopathy is that many of its remedies are low-risk. However, "it is widely recognized that there are much greater risks from conventional medical treatment" strikes me as something an encyclopedia cannot subscribe to without a lot more evidence.


:::I'm not clear what you're proposing. I certainly understand why a doc wants to spend more time with his/her patients, though time and attention alone are inadequate for proper treatment.  It is more important what is and isn't prescribed. [[User:Dana Ullman|Dana Ullman]] 13:32, 28 October 2008 (UTC)
: In any case, I do not think a detailed discussion of risk issues belongs in the lede. I am inclined to thin the lede should raise the question, and in my opinion the current text does that adequately. [[User:Sandy Harris|Sandy Harris]] 04:12, 15 September 2010 (UTC)


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


Ramanand Jhingade wrote the italicized part here: "Medical organisations advise that there is no evidence that homeopathic remedies are effective in these circumstances, and recommend that they should only ever be used in conjunction with conventional medical treatment; ''to this, homeopaths say that ignorant people should not comment about something they don't know about because they heal asthma and bronchitis day in and day out successfully - they also point to a study where a homeopathic remedy has been used to shorten the duration of acute bronchitis.''"
::It's one thing to say that homeopathic remedies might be lower-risk in non-emergent situations, but that isn't what is being said. Of course, one could also say "it is widely recognized that there are much greater benefits, in serious conditions, from appropriate conventional therapy."  No, appropriate conventional therapy does not, as been charged, extend to antibiotics for uncomplicated otitis media. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:38, 15 September 2010 (UTC)


I believe this contains a serious breach of our rules.  It is problematic enough to say on talk pages that your opponents are "ignorant," but to put the insult into the article itself is distinctly unprofessional.  I'll be addressing this further in e-mail with Mr. Jhingade. --[[User:Larry Sanger|Larry Sanger]] 03:12, 26 October 2008 (UTC)
:::In due respect, no one (!) has said or suggested that homeopathic medicines should be a treatment of first resort for heart attacks.  THIS is what I mean by my concern for your tendency to create fights/arguments.  Let's both avoid creating straw men. That said, I agree with Sandy that the lede should not have a detailed discussion of risks issues, though I would think that we might all agree that it is widely recognized that homeopathic medicines themselves are "basically safe."  Also, can I ask us all to try to avoid inserting our own comments within the comments of other writers because it makes it challenging for people to determine who is saying what.  Thanx. [[User:Dana Ullman|Dana Ullman]] 16:51, 19 September 2010 (UTC)
:What's really frustrating is that many of the questions relating to these issues are ignored on the talk page itself. This problematic sentence is a clear instance where it needs to be resolved on the talk page first.  To keep editing such a sentence in the article when there is clearly objections from both sides is not contructive. Let alone throwing out insults too. [[User:Chris Day|Chris Day]] 16:56, 26 October 2008 (UTC)


:I have written to Ramanand too to express my desire that he be a lot more diplomatic and respectful to everyone on CZ.  I simply ask us all to not tolerate abuse but at the same time to try to sympathetic to those of us different experiences from the majority. [[User:Dana Ullman|Dana Ullman]] 01:48, 28 October 2008 (UTC)
::::If it's alternative medicine, then it is the first resort. If it's complementary medicine, then there should be guidelines for the scope of practice of homeopathy. In the past, however, Ramanand has said homeopathy should be a first reatment for all manner of conditions.  There was an extensive argument about acute asthmatic attacks, which, as I remember,  


== The Introduction ==
::::I am not creating a straw man. Please document when homeopathy should not be the treatment of first resort. Otherwise, I'll assume alternative medicine with no limitations.  
IMO Howard added a bunch of stuff that didn't seem appropriate for the Introduction. I have made some edits and am open for discussion.  We previously had some other material here that was quite balanced, but it isn't there anymore.  Perhaps we can begin to resurrect it because it now needs work. That sentence about mainstream medicine is simply dangling (and I have no intention of deleting it).   [[User:Dana Ullman|Dana Ullman]] 23:07, 26 October 2008 (UTC)


:I'm open to making that sentence less dangling, but I don't see any way to do so without explaining some of the reasons that, to put it as gently as possible, mainstream medicine and homeopathy aren't communicating. There are, I believe, two separable parts of the problem.  One is efficacy of treatment and the very different views on '''contemporary''' medication. The other is more theoretical, and gets into what seems to me is a fundamental view of how the human body works. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:55, 27 October 2008 (UTC)
::::Let me clarify my position. I would tend to say that homeopathic medications, themselves, are basically safe. I am very concerned that homeopa<u>thy</u>, as a system of treatment, can be as deadly dangerous as a non-surgeon trying an advanced surgical procedure. You have yet to give information that documents what limitations homeopaths accept.  


::The introduction should primarily provide summary info, and the material that you previously inserted did not do that.
::::Please stop with the straw man accusations. I do not believe that any consensus is possible between alternative (i.e., not complementary) medicine and coventional medicine. Actually, I'd be far more likely to consult a shamanic healer than a homeopath, as there's a fair bit of documentation that shamans have a good understanding of psychosomatic medicine. I don't know what consensus could exist between someone that rejects the idea of treating the pathogens of infectious disease, and someone that has an understanding of modern microbiology. We, sir, are not on the same side and will not be. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:24, 19 September 2010 (UTC)


::At present, there are now two separate paragraphs in the intro that discuss "vital force." We also need to merge those.  [[User:Dana Ullman|Dana Ullman]] 13:15, 27 October 2008 (UTC)
=== Rest of article ===
Further evidence of the strong POV and non-encyclopedic tone of this Draft is:


:::Again in the interest of compromise, I'm perfectly willing to have that information elsewhere in the article. My understanding of the CZ approach is that the appropriate way to handle that would be to cut it out, paste it to the talk page, and then ask several questions:
--under OVERVIEW: The first two sentences are “attack sentence.”  It is clearly inappropriate to provide critique of a subject before adequately describing it FIRST.  Those sentences must be removed or placed elsewhere.
:::*Is this information accurately summarized and/or cited?
:::*Where is the best place to put it, if not the introduction?
:::*Just a "this does not belong in this article" is insufficient justification for removal without relocation. In this case, I believe there is value in pointing out some of the fundamental conceptual conflicts between homeopathy and biomedicine, as long as it is somewhere.


:::Deleting material simply because an individual thinks it is in the wrong place is not within the ground rules. Temporarily moving it to the discussion page is perfectly reasonable.
: I'd say at least the entire first paragraph and probably the whole "Overview" section should be deleted. None of it is real overview of the field. [[User:Sandy Harris|Sandy Harris]] 03:50, 14 September 2010 (UTC)


:::Without clearly identifying where homeopathic and biomedical viewpoints are clashing, there is no chance of improving the communication, or, ideally, starting some sharing of ideas. You bring up, appropriately, "vital force". That term is a cornerstone of homeopathy, and perhaps it should stand as axiomatic rather than trying to find a possibly-nonexistent counterpart in medicine. I'm not sure that homeostasis is quite equivalent, and I'm sure "immune system" is not. Other collaborative phrasings would be welcome. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:05, 27 October 2008 (UTC)
:: I agree with Sandy.  There is no need for this "Overview" section, though I do believe that we need to place some of this information about the status and popularity of homeopathy in a section "Homeopathy in Practice." [[User:Dana Ullman|Dana Ullman]] 15:45, 14 September 2010 (UTC)


Howard, IF there was some type of consensus for what you have written, it might have been appropriate for me to follow your desire to cut and paste the deleted material on the Talk page, but there was no such consensus.
-- under OVERVIEW:  Some sentences here are just confusing, especially this one and especially its last phrase:  They are interested too in why some studies appear to have positive outcomes—do these reflect real efficacy, or can they be accounted for by flaws in study design or in statistical analysis, or "publication bias"—the tendency for small studies with chance positive outcomes to be published while studies with negative or inconclusive outcomes are not.


Vital force is equivalent to the overall immune and defense system of the person. That said, I have written 8 books on homeopathy, and only one happened to mention the words "vital force." As it turns out, no homeopath has ever noticed that the words "vital force" were not in there.  I reason that I don't commonly use the term is that I prefer to refer to a person's immune and defense system...or sometimes, simply to a person's overall defense system.
-- under HISTORICAL ORIGINS, it is confusing and surprising how or why Paracelsus was described as an “astrologer.”  This field was not a primary area of his contributions.  Just as the bio for Isaac Newton does not describe him as an astrologer, even though he actually wrote more on THIS subject than on mechanistic physics, we editors here know that Newton’s primary contributions to the modern-day have nothing to do with astrology.  Needless to say, people here who want homeopathy to sound “quackish” tend to provide this biased information.


The word "homeostasis" is not commonly used in homeopathy.[[User:Dana Ullman|Dana Ullman]] 02:21, 28 October 2008 (UTC)
-- under HISTORICAL ORIGINS:  Inaccurate information has been provided about the present status of the word “allopathy.”  There is a long AND significant modern-day usage of this term by conventional medical organizations, medical schools, and state and national governments. Evidence for this is at: http://en.wikipedia.org/wiki/Talk:Allopathic_medicine (see “Hopping's huge list of links).  Clearly, the term “allopathy” is still in extremely common usage, and it is simply inaccurate to say that it isn’t.  In this light, Osler’s quote has no meaning here, though it may have a place in the article on “allopathy.”


:"Defense system" or "overall defense system" seem perfectly reasonable terms. "Immune system" would worry me as getting into things that are rather specifically defined. We both agree homeostasis should go.
-- under THE LAW OF SIMILARS: As much as I like the subject of “hormesis,” I do not associate its application with the law of similars nor do I know any reference to that. As such, the word “hormesis” has no place in THIS section.  We could replace this word, hormesis, with the word “pheromones” because these substances are known to have a powerful effect in extremely small doses AND it is widely known that pheromones from one species are only sensed by those of a “similar” species.


:If I don't seem to be going too mystic, :-) I wonder if homeopaths might use terms aligned to some used in Asian martial arts, and associated meditative practices. "Balance" means far more than not having one's weight properly aligned. It may not be homeopathic terminology, but I'm somehow reminded of my sensei demanding "finding one's center". When the terminology isn't being antagonistic, I wonder if there may be multiple paths to a similar destination. I wonder if there may not be more room for agreement about the mind-body relationship than the memory of water.
-- under CLINICAL TRIALS TESTING THE EFFICACY…
There are many sentences and paragraphs here that I could recommend changes, but I will emphasize those that are most important or most incorrect:


:This doesn't mean that I didn't absolutely agree with the necessity for invasive procedures for my heart disease; it does mean that I didn't want sedation, just my own set of monitors. To the best of my knowledge, however, I remain the only person, in the history of NIH Clinical Center, to have cooperated in a specialized electrophysiologic mapping of my heart to the words of the Monty Python Blue Parrot. The cardiology fellow was English, and we raised a joint defense system to the head of interventional cardiology, who likes Country & Western playing during his procedures. We made it quite clear to him that "Achy Breaky Heart" is inappropriate for the angiography suite. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:50, 28 October 2008 (UTC)
I recommend removal of the following short paragraph & its accompanying quote.
===Followup===
In the introduction, I'll try to make changes to which I think we are in agreement.


A procedural note: the CZ concept of cutting and pasting to the talk page is not intended for situations where there is consensus, or even consensus in a subgroup. The CZ concept of cutting and pasting to the talk page is intended for situations where there is a ''lack of consensus'', with the intention of seeking consensus through talk page discussion. In general, deletions other than clear copy editing should tend to move to the talk page; there can be exceptions for Constables, Editors, and, perhaps, when there are things that are obvious rules violations.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:30, 28 October 2008 (UTC)
::While many of these have indicated positive effects, generally, trials that are larger high-quality trials have tended to show little or no statistically significant effects, as was concluded by the authors of the second Lancet study cited above when they re-analyzed these trials.  
:: “There is increasing evidence that more rigorous trials tend to yield less optimistic results than trials with less precautions against bias.”[98]


::"Balance" and "center" are lovely words, but neither are used in homeopathy.  I still believe that the words "immune and defense systems" makes sense, and the references that I previously provided to the work of Dr. Paolo Bellavite show the body of work in this area.  Another body of basic science research on one unique homeopathic formula, called Canova, is worthy of your attention (Howard, YOU, in particular, will be surprisingly impressed by this work):  http://canovadobrasil.com.br/english/works.htm  -- what is so convenient about this site is that readers can access the original published articles.  Here's the latest clinical trial, albeit a pilot:  http://www.aids2008.org/Pag/Abstracts.aspx?AID=15800  [[User:Dana Ullman|Dana Ullman]] 13:27, 28 October 2008 (UTC)
My explanation: First, the quote does not verify the sentence it is supposed to substantiate.  Second, the article it quotes also asserts that it is a general finding in ALL clinical research that the higher quality trials tend to show less positive results.  Third, the fact of the matter is that there are many high quality trials published in “high impact” journals that have shown statistically significant effects, including the four trials by Reilly, et al, the four trials on the treatment of influenza using Oscillococcinum, and the three trials on childhood diarrhea by Jacobs, et al.


:::I just made some changes to which I thought we agreed, and tried some flow editing to move some dangling text. Is it not accurate to say that homeopaths no longer use '''vital force''', but Hahnemann did use it and it will appear in historical works?
We need to be careful in our review of research to avoid skewing the facts with “fudge” words. For instance, one could say that the “collective evidence” of the thousands of studies conducted by Thomas Edison was that electricity was not possible (because only ONE experiment in 1,000+ worked). 


:::"Defense system" is fine, but as soon as "immune" is added, that creates an expectation, to most people of a conventional biomedical bent, that there will be measurable immune stimulation (e.g., with GM-CSF: [[granulocyte-macrophage colony-stimulating factor]]), immunosuppression at various levels of specificity (e.g., fairly general with [[corticosteroid]]s and [[methotrexate]], but much more specific with [[anti-rejection drug]]s such as [[tacrolimus]] and [[thalidomide]] -- and yes, the more specific category may suppress the results of immune response, such as [[tumor necrosis factor-alpha]], rather than the immune response itself).
The challenge that we have in describing the efficacy (or lack of it) using homeopathic medicines is that we have to evaluate internal validity (how “high quality” were the trials?) AND external validity (is the specific medicine tested commonly used by homeopaths to treat people with that specific condition?).  Skeptics of homeopathy tend to evaluate the internal validity issues and totally ignore the external validity issues…and BOTH are essential.  To ignore external validity is akin to saying that antibiotics do not work for infections because the “collective weight” of studies on viral, fungal, and bacterial infection shows that these drugs do not work for this common group of diseases. Get it?


:::Can we stay with "defense" to avoid setting off the medical medical defense against immunity? :-)
:No. I don't get it, because I can demonstrate, ''in vivo'' and ''in vitro'', that antibiotics do work for viral, fungal and bacterial infections.  This is hand-waving and hardly encyclopedic.


:::I will look at that article today, although it is a day subject to interrupts -- at some point, the household mechanical genius will finish work on my new used car, and will want to ride immediately. For most of my adult life, I lived in cities and avoided driving. For almost three years, I've had to live, carless, in some semi-rural areas. In Cattish, hissSPIT! [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:45, 28 October 2008 (UTC)
:I have repeatedly challenged you to respond to why homeopaths seem uninterested in the sort of trials used for customized pharmacogenomic medicine, which do have internal and external validity, and never have gotten an answer. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)


== Argument for restoring deleted text in introduction ==
:: I am surprised and even a bit shocked to hear your assertion that antibiotics are effective for viral and fungal infections, but I have no interest in arguing with you about these subjects here, though these strange assertions may influence your credibility with others.  I take much more seriously your unfounded assertion that homeopaths are not interested in research that has internal and external validity.  What is your evidence here? 


Dana deleted, <blockquote>This concept comes into conflict with the control systems theory that underlies modern understanding of homeostasis. Homeostatic mechanisms such as [[neurotransmitter|neurotransmission]] are [[closed loop control|closed loops]], with oversecretion variously prevented by reuptake or by inhibitory neurotransmitters &mdash biological systems control themselves by generating "unlikes" or suppressing "likes". [[Autoimmunity|autoimmune diseases]] are caused by a hyperactive immune system, in which there is too much of a "like" Much of homeopathy is rejected by [[medicine|mainstream medicine]]. Hippocrates is celebrated for his ethics and his powers of observation, but his theories about what we now call physiology are totally discredited. </blockquote>
:::Shocked? Now, if you are holding to the generally obsolete assertion that antibiotics are purely natural products, that's one thing. Let's see...viral? Neuraminidase inhibitors for influenza (as well as the older amantadine and rimantidine), ribavirin for Lassa fever and possibly other hemorrhagic fevers, protease inhibitors (as part of HAART) in lowering HIV levels...well, interferons might or might not be considered antibiotics, but have distinct roles in treating viral diseases. Fungal? Amphotericin B (amphotericin B lipid complex, amphotericin B cholesteryl sulfate, and liposomal amphotericin B); the conazole series; griseofulvin; flucytosine -- and that's not considering topical-only agents. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:07, 14 September 2010 (UTC)


He replaced it with
::::Howard, you're missing my point here. My point is that one must be careful using the term "weight of evidence" because such terms group together various disparate treatments for various disparate conditions.  Although I used the term "antibiotics," perhaps I should have used a name of a specific antibiotic, thereby showing that it may be effective for one type of infection but not for "all types" of infection. Likewise, testing homeopathic Arnica for one ailment may prove efficacious, but testing it for two other ailments might show that it is ineffective. One should not say that the "weight of evidence" is that Arnica is not effective.  Instead, it is more accurate to say that Arnica is effective one condition but ineffective for two others.  Get it now?  I hope so...
<blockquote>and which has been used in various medical treatments since then by a wide range of cultures.''ref''Linn Boyd, The Simile in Medicine. Philadelphia: Boericke and Tafel, 1936. This book was dedicated to the Regents of the University of Michigan, where Boyd served as professor''ref''</blockquote>


The '''ideas''' in the deleted text, I believe, is important to have in the introduction, because it is important for the reader to understand some of the conflicts between medicine and homeopathy. "Like cures like" is a fundamental premise of homeopathy, and it is restated elsewhere in the article. Somehow, it has gotten mixed in with vital force and homeostasis.
::::My intention is not to "fight."  My intention is for us to work together to provide verifable accuracy. [[User:Dana Ullman|Dana Ullman]] 22:37, 14 September 2010 (UTC)


"Like cures like", I believe, grates on anyone familiar with homeostatic mechanisms. Homeostasis, as I mentioned, is essentially a closed loop control system. Such systems are regulated by what control engineers call degenerative or negative feedback. The output of a public address system is amplified sound "like" the input to the microphone. When that amplified "like" feeds into the input, a horrible squeal results, and the system is out of control.
:::::Now I am confused. When you challenged fungi and viruses, it seemed you were challenging the existence of antimicrobial agents (a better term than antibiotic) for those organisms. I gave counterexamples.  


A great many unlike mechanisms are basic to homeostasis and to bodily response mechanisms. These include inhibitory neurotransmitters and presynaptic reuptake to control that there isn't too much "like", the balance among T4 and T8 lymphocytes, etc.
::::No person with reasonable competence in [[infectious disease]] suggests there exists Panaceamycin, good for everything, any more than, presumably, Arnica is good for everything. Antimicrobial agents have reasonably well defined spectra, but, since they are directed against mutable living organisms, any competent hospital has a table ("antibiotogram") of the preferred agents for community-acquired and hospital-acquired infections ''in that locality''.  


I can live with some words, to be worked out, that homeopaths regard the vital force as something like homeostasis, if it is made clear that is an analogy. I believe, however, that the systems biology rejection of "like cures like" is as basic to the comflict between medicine and homeopathy as is the Avogadro argument. There has been no balancing language about that principle, and the article needs it to be encyclopedic.  
::::Now, does the "weight of evidence" support appropriate antibiotic use? Yes! "Appropriate" does not include using antibiotics for self-limiting conditions unlikely to be affected by any antibiotic. Appropriate means considering the overall clinical picture -- sounds like the argument you make about syndromes -- such as not using penicillin G for exquisitely penicillin-sensitive streptococci, if the culture shows coinfection with [[Staphylococcus aureus]] or other penicillinase-secreting organism. One has to consider potential development of resistance, as well as the practical means of administration--if there is no one qualified to inject a parenteral antibiotic in home care, the antibiotic is irrelevant no matter how effective it may be against the organism. If there's a choice in a patient with a hearing loss, you avoid the especially ototoxic aminoglycosides.  


Rather than compromise and agree that "like cures like" is a problem, the response was to put yet another non-comtemporary endorsement of homeopathic principles.  
::::Incidentally, I was just scratching the cognitive process in determining how to treat an infection. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:03, 15 September 2010 (UTC)


'''A proposed compromise''': take out the control systems theory, and simply state that biological science does not accept the principle of "like cures like", noting that it is a cornerstone of homeopathy, necessary to homeopathy, but an area where the disciplines clash. Rephrase that to say even more strongly that it is a foundation of homeopathy.
:: Just as doing double-blind and placebo controlled research testing surgical procedures have their methodological and ethical challenges, research on homeopathy has to be sensitive to the method itself.  You cannot just test a homeopathic medicine and its effects on a bacteria in a petrie dish, nor can I test acupuncture by putting a needle in a petric dish full of bacteria.  You've been told this many times in the past, and yet, you repeatedly feign ignorance about homeopathy and homeopathic research.  Please...you're a smart guy. Let's discuss research that does exist. [[User:Dana Ullman|Dana Ullman]] 15:59, 14 September 2010 (UTC)


Could we PLEASE cut back on justifying things based on things decades, centuries, and millenia ago? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:23, 26 October 2008 (UTC)
:::I repeat: there are usable methods that have been described for pharmacogenetic medicine. Let the clinician diagnose the individual treatment and send orders for it to the pharmacy. The pharmacy breaks the blinding code and dispenses either the ordered individual treatment or the control arm, the latter which may or may not be placebo. The safety committee monitors, and, assuming the study goes to completion, statistically evaluates the hypothesis that the experimental treatment arm is superior to control.


:Howard, perhaps my deletion of your material and my addition of new material should have been two separate edits. I didn't mean my additional material to be a "replacement" for yours. Please treat them as separate.
:::Incidentally, the piece of laboratory glassware is a Petri dish. If, however, you are referring to bacterial sensitivity testing, production tends to be done with radiochemistry, radioimmune reactions, or immunofluorescence. Consider me dumb since I don't know I'm feigning ignorance about homeopathy. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:07, 14 September 2010 (UTC)


:Are you suggesting that the human body is a closed system?  I hope not because that would be wrong.
:::"I've been told"...but by someone I find plausible? You have yet to answer my question about the cognitive process of a homeopathic session, claiming that only a homeopath can understand it, yet no medical discipline makes such a claim of inner mysteries. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:07, 14 September 2010 (UTC)


:And no, homeopathy has a history, and its present status is connected to it. Like I have said elsewhere, should acupuncture only be presented in light of modern or "reductionistic scientific" understandings? (I hope not) [[User:Dana Ullman|Dana Ullman]] 13:05, 27 October 2008 (UTC)
::::Howard, I am perfectly able to describe the cognitive process of a homeopath, but I don't think THAT has a place here.  I've told you this before (many times!), and yet, you repeated request it.  I'm writing this again because it seems that you don't want to remember.  Sadly, you consistently seem to want to pick a fight, and you make these strange claims about homeopathy and homeopaths without evidence.  To me, it just seems that you have a chip on the shoulder. I have no problems with you making verifiable statements or asking questions, but I do have a problem with you creating boogey-men when none exist. 


::Many of the '''control systems''' of the human body are closed loop. I use closed loop in a specific sense of control system theory, in which a mechanism is controlled by degenerative feedback. As one example, presynaptic neurons regulate the amount of serotonin or norepinephrine they release, using reuptake to control the amount of neurotransmitter that can affect the postsynaptic neuron. Where these are excitatory neurotransmitter, GABA is an inhibitory neurotransmitter.
:::: I will say this:  homeopaths usually prescribe their medicines for the overall "syndrome" of the patient, not just their "disease." [[User:Dana Ullman|Dana Ullman]] 22:46, 14 September 2010 (UTC)


::Closed loop has various implementations, but they include the receiver sending an inhibitory signal, or the transmitter self-monitoring and reducing its output. Unfortunately, while in an interpersonal sense, the term "positive feedback" is a nice thing to hear, in the specific context of control system, allowing a transmitted signal to feed into the transmitter's input will send it into oscillation.  
:::::I keep repeating it because you keep refusing to answer it, which I remember very well. Apparently, homeopathy is unique among healing arts and health  sciences in not addressing cognition in practitioners.  


::Many neuromuscular disorders are due to a failure of degenerative feedback mechanism, in which the muscular control centers in the brain either become unable to use proprioceptive information, or the information is not being sent by peripheral neurons.
:::::I suppose that if I can't do better than century-old immunology and pronouncements that regardless of the molecular pharmacology that went into developing a drug, our old buddy similars ''might'' be the real explanation.  


::Medicine has a history. Most general articles on medicine, however, refer to recent developments, or specific and repeatable basic understandings. There is a [[history of homeopathy]] article. There are various articles on historical aspects of medicine, such as [[Hippocrates]], and many more to be written.
:::::Sadly, you consistently want to pick a fight with anyone who doesn't regard homeopathy as the greatest thing for health. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:14, 14 September 2010 (UTC)


===Apropos "laymen" in the introduction===
--Under GOVERNMENT AND INSTITUTIONAL…
I believe it would be more correct to say "mainstream physicians and laymen" share that view of symptoms and disease that homeopaths do not use. It is fair to say, without accusations, that this is one of the most fundamental reasons why there are failures to communicate.  
-- If we choose to include reference to the Great Britain’s House of Commons’ Science and Technology’s report on homeopathy, we have to make it clear that this report was voted on by an extremely small minority of its members.  Of the 14 members, 10 did not consider this issue worthy of voting.  Ultimately, a “majority” of only THREE members voted for this anti-homeopathy report.  Of these 3 votes, two members were so new to the Committee that they did not attend a single hearing on the subject of homeopathy. The third vote for the “report” came from Evan Harris, a vitriolic antagonist to homeopathy who was not re-elected this year, losing to a 20-something year old political neophyte.  Finally, because this report was “advisory” only in nature, the health minister overruled it and didn’t accept its conclusions.  If anyone wants to make reference to THIS report, we have to add these important facts.  I personally suggest that we do not cover this complicated and inconclusive decisions.


Biomedical thinking certainly accepts susceptibility factors as part of the overall picture of infectious disease, but they focus on the pathogen. [[Koch's postulates]], as evolved, do not address susceptibility; they address the subset of infectious disease that involves the pathogen. The medical emphasis, however, is much more on the pathogen. Now, there is certainly the awareness of genetic resistance factors, such as the value of the sickle-cell trait to the most lethal form of [[malaria]] caused by ''Plasmodium falciparum''. The idea of opportunistic infections that take place when a person is immunosuppressed is rather fundamental, but the approach taken depends on the nature of what causes the immune disorder. Genetic errors such as severe combined immunodeficiency, or disease such as advanced HIV attacking T4 lymphocytes, are treated with measures such as chemoprophylaxis or passive immunization. When a myeloproliferative disorder is involved, more active measures to stimulate or replace damaged marrow are taken. One of the greatest challenges, of course, is to manage graft-versus-host rejection of transplanted organs; ideally, one would suppress only the immunity against the transplanted cell antigens.
It should also be noted that whoever wrote the above was obviously also aware of these facts and choose not to present them. This type of biased reporting should not have a voice here. Let’s strive for more encyclopedic objectivity.
[[User:Dana Ullman|Dana Ullman]] 01:21, 14 September 2010 (UTC)


Using "symptom" as a broad term to include signs, laboratory tests, etc., killing a pathogen may not be the goal of medical therapy for an infectious disease. With botulism, there are probably no ''Clostridium botulinum'' cells active in the patient. With tetanus, especially when the entry point of ''Cl. tetani'' is unknown, the emphasis is on neutralizing the bacterial exotoxin and treating its toxic effects such as convulsions; an antibiotic active against the organism would probably be given, but seen as supportive. Management of cholera, especially during epidemics, absolutely requires proper fluid replacement, but antibiotics to kill ''Vibrio cholerae'' are not required for most patients. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:26, 29 October 2008 (UTC)
:Repeated defenses of homeopathy, with nothing more than supposition and coincidences, don't belong here either. In my opinion, Mr. Ullman, you will not regard anything short of an article that gives homeopathy as much credibility as conventional medicine as acceptable -- and that, sir, is a promo. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)


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


Need I quote the text surrounding that word, again? Putting the one word in quotes overemphasizes, I believe, the actual language, making more of an argument for homeopathy than do the investigators. To get some consensus, here are the last three sentences of the abstract, with '''promising''' in context:
If anyone used the principle of similars to plan these treatments, there might be a case. I sincerely doubt, however, that this was ever done; the advocates making after-the-fact, observational rather than molecular, correlations that are extremely dubious. Take a modern immunization, especially an acellular one -- it is designed on a molecular basis to produce desired immunoglobulins and other specific substances; similars were not involved in the design.  It's rather hard to say that "similars" is a ''better'' explanation than what the molecular pharmacologists intended, and can demonstrate.


<blockquote>Though '''promising''', the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.</blockquote>
Are there homeopathic provings that demonstrate that large doses of cromolyns cause basophil and mast cell degranulation? If not, the molecular explanation that they desensitize the granules, and in turn block the release of histamine and other inflammatory messengers, is a much better shave with Occam's Razor.  


Source: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001957/frame.html
I hope we do not have as lengthy a debate on the Tooth Fairy, especially from advocates that are America's leading spokesman for tooth fairies and thus have a financial conflict of interest. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:57, 14 September 2010 (UTC)


The conclusions are not quite an endorsement for homeopathy. Other changes made to the text, changes which I cannot interpret as other than an attempt to deflect anything that is not strongly homeopathy positive, included:
:Just to throw yet another bit of reality, the use of amphetamine-like drugs, as well as non-amphetamine drugs such as Strattera, for attention deficit disorder &mdash; not limited to children &mdash; and not discussing other psychotropic drugs is, to put it mildly, showing selection bias. There's as much evidence of neurotransmitter effects than of "similars". Further, if one were to generalize to other psychotropic drugs, one couldn't use the principles of similars to produce hypomania in a normal control.  It has repeatedly been demonstrated that lithium carbonate, for example, is not euphoriant. In high doses, it's a depressant -- remarkably so, since the subject will be dead. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)


"there is no '''established''' mechanism of action" became "there is no '''definite or widely accepted''' mechanism". What was untrue about "established"?
:: We cite in this article a quote from Emil Adolph von Behring (the "father of immunology") who asserts, "In spite of all scientific speculations and experiments regarding smallpox vaccination, Jenner’s discovery remained an erratic blocking medicine, till the biochemically thinking Pasteur, devoid of all medical classroom knowledge, traced the origin of this therapeutic block to a principle which cannot better be characterized than by Hahnemann’s word: homeopathic."  Whether physicians today (or yesterday) refuse to believe that the "principle of similars" is utilized in medicine, it still can be asserted that they are consciously or subconsciously utilizing it.  This is NOT to say that ALL drugs are prescribed by this principle (Howard creates a straw man argument with his reference to lithium carbonate). Further, just because there are other explanations for how or why Ritalin works does not take away the fact that the "similars" principle may also be at play.  [[User:Dana Ullman|Dana Ullman]] 16:14, 14 September 2010 (UTC)


Further, the earlier text containing the '''promising''' read: "Data from the treatment trials showed enough efficacy '''that''' further trials were recommended, '''but''' that the remedy could not be recommended for first-line therapy." This was changed, I believe substantively and inaccurately, to "Data from the treatment trials showed enough efficacy '''to be consider [sic] "promising," though''' further trials were recommended and that the remedy could not be recommended for first-line therapy."
:::Ah yes. von Behring. 1901 Nobel Prize for 19th century work. Got some authoritative immunology less than a century old?  Maybe someone that knew about immunoglobulins?


Larry, I cannot interpret this as other than an attempt to rephrase a straightforward, and not completely anti-homeopathic, text into language that became actively supportive of it. The changes, I believe, distorted meaning. I reverted them. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:37, 26 October 2008 (UTC)
:::"It can be asserted" and "just because there are other explanations" doesn't support similars, any more than the Illuminati ''might'' be responsible for all evil in international relations. "Might" isn't encyclopedic.


:Yeah, I look forward to hearing Larry's input here too. Although I inserted the word "promising" because THAT was the word used in the text, our information on this study also provided the SAME qualifications that are provided in the rest of the sentence.  The only part of the sentence that was previously left out was the word "promising" (thus, it deserves to be put back in for accuracy).
:::Actually, I prefer the wicker man to the straw man.  


:As for "established" vs. "definite or widely accepted," I thought that I was providing more precision to the article.  I'm not clear on what "established" means here, while "definite and widely accepted" is a lot more clear. [[User:Dana Ullman|Dana Ullman]] 13:11, 27 October 2008 (UTC)
:::I'm disgusted, but I will not give up because the integrity of CZ means something to me. To stop responding to handwaving would be to give in to the stamina of homeopathic advocates.  


== In a cooperative spirit, "The Typical Homeopathic Visit" ==
:::You were the one that brought up various drugs. I added lithium carbonate as one example. How is it a straw man?  In therapeutic doses, it has no effect on non-hypomanic patients. Easy to call things straw men when you don't like them, and drop back to "it can be asserted." The capability of assertion does not make for encyclopedic quality. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:16, 14 September 2010 (UTC)


Hoping that some author-author interactions yesterday, helped the mind-mind relationship, I looked at some things that might improve clarity and flow. Waking up (too early, and now having to search for a reserve of coffeemaker filters), I was also happy to see Gareth had tightened a few things that had bothered my editing sense.
===Regarding 'point of view'===


Turning to a larger topic, the section, "The Typical Homeopathic Visit", is a mixture of useful information, point-counterpoint argument of increasing intensity, and a bit of redundancy. As a start, I inserted some lower-level subheads simply to help things I'd like to address. ''Italics'' are not saying that there is not important information in the subsection, but, if possible, it should be moved to another part of the article and internally wikilinked; the arguments interfere with understanding something I consider very key: the homeopath-patient interaction. While I shall be bombarded by clathrates and microbubbles for saying this, I believe understanding the dynamics here may be more important than yet another Avogadro-related argument.
No "point-of-view" disparagement required for conclusions/inferences drawn from science. Any such disparagement itself reflects "point-of-view". The lede as it reads now reflects medical science's judgment of homeopathy. Personally, as a scientist, I consider an open mind a virtue, but I try not to have it so open my skeptical inquirer falls out. [[User:Anthony.Sebastian|Anthony.Sebastian]] 03:16, 14 September 2010 (UTC)


*''Conflict as to when conventional medicine may be necessary'' Can we find some wording, acceptable to both viewpoints, that acknowledges that medicine is concerned that certain seemingly mild conditions may need immediate life-saving interventions? The issue of delay in seeking appropriate medical treatment when delay is important but not actively dangerous is another. Anecdote not being the singular of data, I lost a relative and close friend who had continued to see an alternative practitioner, not a homeopath, who kept treating a complaint of  pain according to his discipline, over a two week period. The nature of the pain and other symptoms should have strongly suggested an internal organ origin, but only after he collapsed, rushed into the emergency department resuscitation bay bypassing the paperwork, was a rupture of an abdominal aortic aneurysm confirmed. We have better and more widely available interventions now, but, at this time, there was nothing to do than a deathwatch of 18 hours. 
:As I've suggested, we have to face the issue that the two advocates appear not to want the general judgment to appear, unless it is immediately accompanied by a Seinfeld-like "but that's OK, and homeopathy works." [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)
::Treatment of cancer and other, more controversial conditions where many physicians are open to complementary, but not alternative care, for life-threatening conditions are another matter.
::Let me be clear that I've either taken a person for whom I was the advocate, or done it myself, and left a physician office, going to an emergency room or to a specialist I could reach quickly, because I was convinced the physician was making bad assumptions. I've also fired physicians from hospital care. Physicians are definitely not perfect, but they are much better than they were in 1810, 1910, or 1960, and I have a sense homeopaths either reject that idea or are just angry about the past.
*'''Approach to the entire patient''':  this is an important section where much more detail about homeopathic thought would be welcome. Even if the remedies may do nothing, I will accept that there may well in the interpersonal part of the process. At the same time, I'd like to reduce the insistence that conventional physicians never consider the entire patient, emotional state, etc.
*''Conflict on individualization'': Again, we get into one of the areas that homeopaths seem to insist is unique to them, but, purely from a mathematical standpoint, does not seem consistent with points made here. Can we condense here, try to find a less antagonistic formulation, and have the detailed discussion elsewhere?
*''Conditions where individualization may not be needed'', in part, repeats points in ''Homeopathy and trauma''. If nothing else, there is internal conflict even in the subsections, and I believe there is a need for more material on homeopathic thinking on trauma and other conditions for which surgical intervention may be appropriate.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 12:56, 28 October 2008 (UTC)


== Organizational question ==
== Biology-Health Sciences Editor ruling needed ==


In the present article, there are two top-level sections on safety issues at the end of the article. While the language toward the very last has the flavor of a wrap-up (as opposed to conclusion), certainly, in medical testing, safety is assessed before efficacy.
Immunology clearly falls into these fields, ''not'' Healing Arts. I contend that it is ludicrous for this article to be using von Behring as a source of authority. It's fair enough to mention a 1901 Nobel Prize winner in a historic context, but a ruling is needed if his statements on homeopathy and immunotherapy can be used as substantiation for plausible modes of immune response. Immunology has progressed a bit in over a century.


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


Once that was done, I propose to move the "safety" section after "scientific basis of homeopathy" but before efficacy. As I've said, safety tests (FDA Phase I) precede efficacy tests (Phases II and III), so I believe the proposal would make the article have a more customary flow.
(undent) All of you make good points, but the specific may be a little easier. If I were to state the problem in EC terms, it is that different disciplines acquire knowledge at different rates. Were this, for example, a Literature article, Oscar Wilde or G. B. Shaw's comments would be relevant. If this were aviation engineering, however, I think it is relatively obvious that Orville and Wilbur Wright's commentary would not be very relevant to an Airbus (most recent model) or Boeing 787 Dreamliner. While I've often wondered how a classic military genius such as Belisarius would do with airmobile forces, he'd have a bit of catching up.


Since human subject review boards, even before safety studies, want to see theoretical, ''in vitro'', and ''in vivo'' studies in nonhumans before approving Phase I or the national equivalent, I believe this material should precede "Safety". I'm not sure "Scientific basis of homeopathy" is the most descriptive title, and would be open to hearing alternative suggestions.
Von Behring, and indeed Hahnemann, were giants in their time. Today, however, von Behring wouldn't know how to find  his way to the protein sequencer or the molecular visualization workstation.  


If the idea of trying to follow the structure of ethically approved testing makes sense, I would also propose moving the ''in vitro'' and animal studies into whatever-theory-gets-called.
The policy, therefore, might say that to cite an authority as more than a historic point, that authority has to be reasonably familiar with current concepts. It may be even faster now, but, a few years ago, based on MEDLINE growth, the amount of information in health sciences doubled every seven years. Some fields, such as molecular pharmacology, went from nonexistent to major disciplines.  There's not going to be a citation that "Von Behring is obsolete", but that's a reasonable inference.


I'm not sure of the best way to handle the flow of matters such as the ''Lancet'' controversy. The best that I can say is the text preceding the specifics should have a reasonable summary of the issues. Indeed, the introductory text at the start efficiency might have a summary of, and justification for, each of its major subsections. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:55, 28 October 2008 (UTC)
Peter, I would be absolutely delighted to have an article on the legality of the Iraq War. The article is not now affiliated with law, or several other relevant workgroups, due to the three workgroup limit. In doing the main draft of these articles, I had quite enough to do with the "what" and "how" without getting into the just war theory or international law. I would be happy, over an appropriate beverage, to discuss what I personally consider to be vague language in the UN Charter.


== Vital force and Symptoms ==
Unquestionably, Matt, workgroups need to be revised. I have been doing some experimentation with subgroups, but they are not a sole answer. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:19, 15 September 2010 (UTC)
Friends, I got misunderstood (but understandably such). I have rewritten some info in the Intro about the "vital force" (although I don't usually use this term myself, it IS a part of homeopathic theory...and it should be mentioned...and then explained, which is what I tried to do.  I hope that I've rewritten this in a way that is understandable and clear and am willing to work with you all to make it better.  [[User:Dana Ullman|Dana Ullman]] 01:59, 29 October 2008 (UTC)


== Harold Griffith, MD ==
: I think the word "ruling" in the section title is an error. Certainly ''comment'', or even ''contributions'', from those editors would be useful and (I assume) welcomed by all concerned, but I do not think they have the authority to ''rule'' here.
Howard previously expressed great respect for Harold Griffith, MD, and Howard expressed surprise to learn that Griffith was also a homeopath. Howard has been resistant to bring "historical" references in this article, while I insist that history is an integral part of homeopathy's story, especially for an encyclopedia.  I am inserting here an excerpt from my book, "The Homeopathic Revolution," to give Howard and others a sense of how somewhat distant history merges with quite research history, as is the case with Griffith and his father.  Of special interest is Griffith's experience in using homeopathic medicines to treat many serious illnesses and claim quite significant results with homeopathic treatment.  While it may not be appropriate to give reference to just any person or physician who makes such claims, this information may deserve achieve notability because of its source.


Needless to say, because I own the copyright to my book, I am allowed to insert this material here: 
: The paragraph quoting von Behrig starts "Scientists and medical doctors today do not think that the principle of similars is generally true or useful, and they explain the efficacy of vaccination without referring to it. Physicians of the 19th century however did consider that the principle could be valuable." That strikes me as fair. Given that context-creating text, I see no objection to the von B quote.


"Although the name of Dr. Harold Griffith (1894–1985) may not be familiar, he was a giant in the field of anesthesia. In fact, one of Dr. Griffith’s biographers succinctly summarized his medical contribution: “It has been said there are only two eras in anesthesia, before Harold Griffith and after” (Canadian Anesthesiologists’ Society).
: As I see it, there are serious issues with this article, and Howard is right about most of them. However, on this particular point, I see him as tilting at a windmill. [[User:Sandy Harris|Sandy Harris]] 02:52, 16 September 2010 (UTC)


Harold Griffith’s father was Alexander Randall Griffith, MD, who graduated from New York Homeopathic Medical College in 1891 and from New York Ophthalmic Hospital’s specialty program in 1892. Dr. Alexander Griffith was medical chief of the Montreal Homeopathic Hospital from 1898 until his death in 1936, at which time his son, Harold, succeeded him. Harold’s brother James was surgeon-in-chief from 1937 to 1966.
:::One never knows...the windmills ''might'' be giants. Seriously, I really don't have a problem with historical quotes in historical contexts. Such contexts, though, would include both Osler's preference for 19th century homeopathy over 19th century allopathy, and his later statement that both allopathy (as used at the time) and homeopathy were both "cults" that needed to be replaced by scientific medicine.


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


Harold Griffith was trained in medicine at McGill University, but due to his special interest in homeopathy, he obtained a homeopathic medical degree from the Hahnemann Medical College in Philadelphia. He moved back to Montreal to work alongside his father and brother, both of whom were homeopathic physicians at the Homeopathic Hospital of Montreal. He became chief of anesthesia at the hospital, where for forty-three years he served as chief anesthetist and thirty-nine years as medical superintendent  (today, this hospital is known as Queen Elizabeth Hospital). Under his direction, the Homeopathic Hospital of Montreal was the first in Canada to have a surgical recovery room (Shephard, 2004).
== Followup on Anthony's comment about alternative medicine ==
Griffith made medical history in 1942 when he became the first doctor in the world to use curare to relax the muscles of a patient undergoing an appendectomy. He was the first president of the Canadian Anesthetists’ Society upon its founding in 1943, and in 1955 became founding president of the World Federation of Societies of Anesthesiologists. In 1951, he became chairman of the department of anesthesiology at McGill University.
One of Griffith’s classmates at the Hahnemann Medical College was Henry Ruth, MD, who stayed and practiced in Philadelphia. Ultimately, this fellow homeopath Dr. Ruth became the founding editor of the leading journal in their field, Anesthesiology, which was published by the American Society of Anesthetists. 


Griffith maintained a lifelong appreciation for homeopathic medicines to prevent the need for surgery, but he was ready, willing, and certainly able to provide his surgical skills when necessary. He prescribed homeopathic medicines to many patients pre- and post-surgery to help in their recovery. During his years at the homeopathic hospital, the most commonly treated diseases included pneumonia, typhoid fever, tuberculosis, puerperal fever as a complication of childbirth, syphilis, pernicious anemia, and diabetes. Despite the serious nature of these and other illnesses, Griffith maintained that homeopathic medicines were a useful therapy in which 60–70 percent of patients responded favorably (Bodman, R., and Gillies, D. Harold Griffith. Toronto: Dundurn Press, 1996, p. 38)." [[User:Dana Ullman|Dana Ullman]] 00:46, 30 October 2008 (UTC)
While I agree with your addition, I wonder if it goes far enough. Complementary and alternative medicine, while often grouped together, are not the same. Alternative medicine, to use NCCAM's definition, is a ''substitute'' for conventional medicine, while complementary medicine can be [[integrative medicine|integrated]] with conventional medicine. Rather by definition, alternative medicine will not agree with conventional medicine, and never the twain shall meet.


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


:Second, I never expressed surprise that Harold Griffith was a homeopath. What I have said about Harold Griffin is that the work for which he received the Nobel Prize in Physiology or Medicine was for anesthesia techniques that, to put it mildly, did not use tiny doses of drugs to reproduce symptoms.
Whether or not homeopathy is CAM rather than AM, this article overwhelmingly treats it as AM. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:50, 14 September 2010 (UTC)


:What I do believe about Griffith is that he was more willing, than many homeopaths, to recognize that there can be other ways, and that homeopathy can be a complementary as well as an alternative discipline. I don't know how to respond to "Despite the serious nature of these and other illnesses, Griffith maintained that homeopathic medicines were a useful therapy in which 60–70 percent of patients responded favorably ", because there are absolutely no specifics, just a statement of opinion.
:Howard, I took a long rest from this article, and it seems that you would really benefit from doing so too.  I realize that by saying this you may now want to edit more often than ever.  My concern is that you are beginning to lash out at me and at this subject in an extremely emotional way. It seems that you are no longer trying to create an encyclopedic article but one that pushes your POV which remain inadequately informed about this subject of homeopathy.  Heck, even when Dr. J sought to reach out to Sandy and be friendly, rather than adverserial, Sandy told him that he wasn't interested.  That's OK too...and Dr. J didn't seek to connect personally.  Let's not make this effort by Dr. J to be as "bad" as you've tried to make it.  [[User:Dana Ullman|Dana Ullman]] 22:54, 14 September 2010 (UTC)


:I suppose I might be, indeed, a bit surprised that there were only two eras in anesthesia, unless, I suppose, one assumes anesthesia of some sort always existed before Griffin. For some strange reason, I'm reminded of a surgeon commenting, in the Bulfinch Dome at Massachusetts General Hospital, "Gentlemen, this is no humbug."
::Well, gee. I've been discovered: my whole motivation is attacking homeopathy, and I '''never, ever''' contribute to anything else at Citizendium.  Obviously, [[New Delhi metallo-beta-lactamase-1 enzyme]] is just an attack on homeopathy, as is [[CZ: Pacific War Subgroup]], as is (quite friendly) collaboration on [[opportunistic encryption]].  


:When an encyclopedia article still does not give a good sense of the day-to-day current practice of homeopathy, but variously leaps into ancient history or argues primary research trials, I do see a problem..  I can think of few areas where human beings practice a discipline for which they cannot outline a coherent set of principles. While somewhat tongue-in-cheek, I did so for [[rocket science]] today, with the caveat that it is a lay term for a set of engineering disciplines. The meat of the structure is in the "related articles" section. If, however, one did want to discuss the specifics of an approach to a tactically innovative way to have a boost-phase intercept of a ballistic missile, one could express a start as in [[NCADE]].
::Why is this in a subsection where I was addressing the complementary and alternative aspects of homeopathy? That was hardly emotional. I neither need nor want your advice or concern on what I should do.  


:Human beings have been using secret means of communications for as long as there has been written language, but it is possible to summarize the fundamental principles of [[cryptography]] in a few paragraphs. Fundamental principles are different than explaining how a Feistel structure helps introduce nonlinearity. Infectious disease is a tremendously complex field, but there are basic structuring concepts such as [[Koch's postulates]].
::It ''is'' adversarial. Deal with it. Mortality & Morbidity conferences, military After-Action Reviews, engineering design reviews, etc., benefit from an adversarial approach.  


:Pablo Picasso tended to frustrate would-be students, for as a basic qualification, he would ask them to draw a clear picture of, oh, a wine bottle and some flowers next to the lamp in the corner. Can't do that? Sorry about that. Come back when you can express the fundamentals. I've spent enough time around artist and galleries to be able to speak of the interesting dynamic of the interwoven conceptualizations of the artist's vision, but I can also draw a cat that looks like a cat, and, indeed, even suggests the texture of a cat.
::As far as I can tell, your definition of "adequately informed" is to accept homeopathy. The Ormus article hurt Citizendium, and I am convinced that homeopathy does as well. I do know that I have had people refuse to join CZ specifically due to the homeopathy article. I'll believe you want to be encyclopedic when I see you contribute to things other than a single issue.


:You have spoken, with apparently high regard, of [[William Osler|Sir William Osler]]. His classic textbook, still being updated,  is ''The Principles and Practices of Medicine''. The first edition clearly distinguished between things he knew, things he did not know, and a systematic way to approach real patients. I still seek an  equivalent description of how one actually practices homeopathy.  With due respect, and hoping that I shall violate neither the family-friendliness policy nor unprofessional language, I shall share a parable, with appropriate updates for non-sexist language, that describes what I have not yet heard. One individual spoke of individual's lover, a gymnast, and how grace and strength made wonderful their lovemaking. The next scoffed, and spoke of a poet as a an even more transcendent lover, who never ceased to cradle with words embracing the soul, as they made physical love.
::If I get extremely emotional about something, I tend to be more quiet, and perhaps smile a lot. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:07, 14 September 2010 (UTC)


:The last, however, laughed at the other two. The lover of that individual was a marketing representative for a Major Computer Company, and, while they never actually made love, it was just wonderful to hear how good it would be when it was finally delivered.
== Encyclopedia Britannica Online: Homeopathy lede ==


:There have been wonderful things said about how wonderful the effects are of homeopathy, but I can't quite figure out exactly what it actually does when it does it. Shall we stop dancing around and write a clear article? So far, I can think of more specific descriptions from Michael Harner and Sir James Frazier.[[User:Howard C. Berkowitz|Howard C. Berkowitz]]
Possibly of interest:
01:31, 30 October 2008 (UTC)


::I'm sorry if my above comments were offensive to you (THAT was not my intent), and I'm a bit confused that you ignored so much of the content here, especially "During his years at the homeopathic hospital, the most commonly treated diseases included pneumonia, typhoid fever, tuberculosis, puerperal fever as a complication of childbirth, syphilis, pernicious anemia, and diabetes. Despite the serious nature of these and other illnesses, Griffith maintained that homeopathic medicines were a useful therapy in which 60–70 percent of patients responded favorably." So, after more than a half century of clinical practice, Griffith found remarkably high results in treating serious illnesses. 
"Homeopathy"


::As for "complementary medicine," most MD homeopaths I know also use some conventional Rx, but they prefer to use safer medicines before resorting to the "bigger guns."  On the other hand, it is the average MD who has seemingly little or no interest in real integrative medicine and instead use ONLY conventional Rx as though they were the only possible or effective treatment. [[User:Dana Ullman|Dana Ullman]] 01:52, 30 October 2008 (UTC)
"a system of therapeutics, notably popular in the 19th century, which was founded on the stated principle that “like cures like,” similia similibus curantur, and which prescribed for patients drugs or other treatments that would produce in healthy persons symptoms of the diseases being treated."


:::Let me try again. I hae absolutely no idea what he actually did for what illness. There is a sentence with a list of illnesses. There is a sentence saying he found homeopathic medicines useful. I don't know if he treated type I diabetes with a 30X dilution of glucose, or protamine zinc insulin. During at least some of his years of practice, there were no effective medical treatments for some of those diseases. Yes, typhoid fever was quite prevalent until water treatment systems were in general use. Now, was he treating typhoid frequently before the effective antibiotics became available? At some point in major cities, it wasn't there.  
"This system of therapeutics based upon the “law of similars” was introduced in 1796 by the German physician Samuel Hahnemann. He claimed that a large dose of quinine, which had been widely used for the successful treatment of malaria, produced in him effects similar to the symptoms of malaria patients. He thus concluded that all diseases were best treated by drugs that produced in healthy persons effects similar to the symptoms of those diseases. He also undertook experiments with a variety of drugs in an effort to prove this. Hahnemann believed that large doses of drugs aggravate illness and that the efficacy of medicines thus increases with dilution. Accordingly, most homeopathists believed in the action of minute doses of medicine."


:::I keep hearing generalities, about how good it was when someone got it, but I don't know what "it" is.  I hear complaints about "average MDs", and don't know your sample. Simply as a patient, much less with the physicians I've worked with on an institutional level, I certainly thought the competent primary physicians took "integrative" approaches, although I can't say I knew any that used homeopathic techniques or referred to homeopaths.  
"To many patients and some physicians, homeopathy was a mild, welcome alternative to bleeding, purging, polypharmacy, and other heavy-handed therapies of the day. In the 20th century, however, homeopathy has been viewed with little favour and has been criticized for focusing on the symptoms rather than on the underlying causes of disease. Homeopathy still has some adherents, and there are a number of national and international societies, including the International Homoeopathic Medical League, headquartered in Bloemendaal, Neth."


:::I see data that suggest that there are good things to be learned from the interpersonal dynamics between homeopath and patient, but I keep getting history rather than the approach in the consultation. The major item of detail I've seen, and unfortunately lost the link, was a repertory that Matt Innis found, but symptom recognition wasn't there.  
http://www.britannica.com/EBchecked/topic/270182/homeopathy


:::I hear a lot of bitterness about physicians, and I'm sure there is reason for bitterness in both directions. I tend to get a bit peckish with people who never seem to get specific, and no, I'm not talking about the memory of water. No, I'm not talking about physicians that see only one way of approaching things. I have no (CZ-family-unfriendly) idea when a homeopathic MD decides that there can be no delay in using a well-defined "big gun", and how decisions are made, in less emergent situations, when to work with a homeopathic remedy. I don't know if you are suggesting that Griffith, for the specifically named infectious diseases, did not use antibiotics for confirmed and active disease, once such a drug was available. There are chronic pain conditions in which I personally believe in a very wide range of conventional and complementary means, but that doesn't, at the present time, include homeopathic remedies because I have no clue what would be selected or why. Somehow, I manage to muddle through understanding how and why things are done in ICU, but I am completely baffled on how one begins to get an equivalent or lesser understanding of homeopathic technique.
[[User:Anthony.Sebastian|Anthony.Sebastian]] 03:27, 16 September 2010 (UTC)


:::What I'm searching for, in this article, is not vaguenesses and metaphors. I have a rather small trauma surgery handbook that fundamentally deals ONLY with the situation when nothing is going according to plan, every physiologic and surgical technique must be adapted to the moment-by-moment situation. It then goes into setting priorities, adapting to the patient and not the chart, not doing too much or too little.  
:The first two paragraphs, I hope, are not controversial. The talk page controversy, however, has significantly involved both homeopathic attempts to claim medical logic, as well as a broader assumption, by the homeopathy advocates, that homeopathy needs to be regarded as having equal credibility to conventional medicine.  Attempts to claim that the principle of similars is the underlying mechanism for medical treatments developed, or validated, using methods of molecular pharmacology fall under my first point. Closely coupled is the homeopathic argument that homeopathy mimics body defenses manifested as symptoms, when the actual defense is quite different than the symptom producing factor -- tetanus is a good example, where the defenses are immunoglobins that have no particular symptom-producing quality, but the symptoms of  spasticity and convulsions are caused ("indirectly") by the exotoxin of ''[[Clostridium tetani]]'' and can be lethal. The defenses neutralize the toxin, and, coupled with antibiotics and surgery, eradicate the source of the toxin.


:::I can equally think of things like multidisciplinary chronic pain centers that don't slam everything with drugs -- but don't hesitate when heroics are needed. So, if you want to keep complaining about conventional physicians, you are free to do so. I will continue to be unable to get any real insight into homeopathy, and I guess I've gotten along so far without doing so. Maybe there's something there, but the emotion and rhetoric seem to be blocking my understanding. My interest in what Hahnemann, in dealing with real-world situations, is about as great as knowing that pernicious anemia could be treated with raw liver, and then injected liver extract, and, eventually, a rather benign approach. George Minot, I'm sure, was a great guy, and it's a wonderful story that he was saved from death as one of the first insulin patients, to go on and get the Nobel for a treatment no one would use. I'm more interested in how to treat pernicious anemia today, and I'm perfectly willing to listen to complements for adequate vitamin B12 delivery, but not substitutes. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:23, 30 October 2008 (UTC)
:In other words, there's a refutation of molecular medical arguments, but no molecular explanation of how similars affect the body. Hand-waving about memory of water isn't on the same level as immune reactions that can be demonstrated ''in vitro'' and ''in vivo'', or structure-activity interactions with cellular receptors. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:12, 16 September 2010 (UTC)


::::Howard, despite all that you've read about homeopathy here and elsewhere, you still do not seem to understand it.  The problem here is that you are looking at it as though it is and even should be just like conventional medicine but just with different drugs.  It is NOT like this.  What you call "vague" is simply your desire for a "this medicine for that disease" mentality.  I hope that one day will be begin to understand that there is a big difference between treating "syndrome" and treating "disease" (to clarify, disease is a part of an overall syndrome).  Although there are rare instances where one can say that there is one specific homeopathic medicine for a specific disease (Oscillococcinum for the flu, for instance), this is the exception to the rule. 
== "Alternative Medicine and the Laws of Physics" ==


::::And yes, Griffith says that he was able to prescribe ONLY homeopathic medicines in the successful treatment of many of the most serious chronic disease that people experienced when in a hospital, even many serious infectious diseases and he even notes diabetes in his list.  I sincerely hope that you can understand the system of homeopathy and stop asking or insisting on what medicine was given for a specific ailment.  Homeopathy and acupuncture have this in common.  [[User:Dana Ullman|Dana Ullman]] 04:25, 30 October 2008 (UTC)
Of possible interest:


===I have offered compromise, and failed.===
Alternative Medicine and the Laws of Physics
First, you are not hearing me. I did not say "what medicine was given for each ailment." What I have asked for, repeatedly, is how the homeopath approaches the individualized encounter.


Second, if acupuncture and homeopathy are alike, than we have more of a problem, because I have what seems to be a reasonable understanding of the Traditional Chinese view of acupuncture theory (e.g., the many pulses used in diagnosis, chi, meridians, acupoints), mixed methods by physicians with both OMD and MD degrees and Virginia licenses in both (acupuncture requires medical licensure in Virginia but not Maryland), and the acupuncture-derived methods used by non-certified pain-management anesthesiologists who worked under the guidance of their acupuncture-expert colleagues. For example, in one pain management group, the acupuncture consultant had degrees from a TCM school and a MD school, and was a board-certified OB/GYN. The anesthesiologist who was their specialist in myofascial and sympathetic injection procedure. They worked in sequence, and they were exploring means of adjusting drug injection points, and even needle manipulation, to add acupuncture to the neurologic approaches. They were making much more use of electrically stimulated acupuncture needles at classic acupoints, and, depending on the individual patient, might change the modality but not the location; they found if non-electrified and electrified acupuncture needles did not work or gave partial response, especially the partial responders might get additional relief from TENS or electrostim. Drugs were used, or not used, depending on the specific situation. I have had partial relief of some pain conditions, and, with the full involvement of my primary internist, the best moderate-term relief was from a clinician dual-certified in chiropractic and physical therapy, who used electrostim, heat, massage, and manipulation. Admittedly, it was especially fascinating to listen, at great length, to My Friend Who Was Female and in a U.S. OMD school; she is about six feet tall, likes very high heels and was an interesting visual contrast to the Asian immigrant faculty. Nevertheless, I have direct experience with MDs, OMDs, DCs, DOs, PTs, assorted meditative and visualization practitioners, and all of whom were happy to discuss, coherently, both their approach and how it related to their colleagues' approach.  
Robert L. Park


Third, as I understand the system of homeopathic practice, the key is the history and physical, and perhaps agreement on integrative practices between homeopath and patient. This is what I have repeatedly asked about, not what medicine for what disease. I'm trying to understand the assesment by which homeopath characterize entire patients, which, somehow, whenever addressed to you becomes "what medicine for what disease", rather than the question I actually asked.
''Skeptical Inquirer'', Volume 21.5, September / October 1997


Fourth, I regard the continued answers to the question on when Griffith used non-homeopathic methods, and homeopathic in combination with medial methods, as being evasive. Clearly, he developed a number of anesthesia techniques that would kill a patient not receiving intensive support; those are hardly the "safer medicines first". He indeed might have chosen to use a traditional homeopathic remedy first, but, in some cases, eventually decided a medical method was needed as well or as a replacement. I have been asking for examples of such decisions, and also confirmation that he did or did not go to medical methods directly in such narrowly defined situations as culture-confirmed severe infection, or type I diabetes. At this point, I must conclude that either we cannot communicate on the most fundamental level, or that you have your reasons for not answering repeatedly rephrased questions which are not seeking the information you keep repeating I seek, or that homeopathy is more a faith-based practice, much like those that tell me that if I accept $DEITY and sincerely pray to her, all will become clear and I will have a peace that passeth understanding.
http://www.csicop.org/si/show/alternative_medicine_and_the_laws_of_physics/


I give up. Go ahead and write whatever you want. If I find some of that to violate (especially) safety-of-life considerations, or a very different medical position, I will state the position side by side, as provided by CZ policy. If I find that you have written material I consider actively dangerous, or rhetorical rather than informative, I shall propose deletions on the talk page, and, if required, go through a formal dispute resolution that might consider how, for example, we have excellent articles discussing the interaction of chiropractic in medicine.
[[User:Anthony.Sebastian|Anthony.Sebastian]] 03:59, 16 September 2010 (UTC)
:Having read the article I feel a neutral way of presenting homeopathy would be something like "it is a type of medicine supported by neither scientific reasoning nor data. that being said this is what homeopaths think: 1, 2, 3." ([[User:Chunbum Park|Chunbum Park]] 05:40, 16 September 2010 (UTC))


As opposed to your repeated characterizations of my motivations, I don't want to speculate on yours. I shall simply focus on a CZ process, in which sincere attempts to discuss and understand repeatedly are deflected into what I find content-free admonitions of my wanting the faith to be other than what $INTERPRETATION of $DEITY says.
:: I think that overstates the case. Homeopathy is based on a system that includes reasoning which is at least pseudo-scientific. There is data, though much of it is of dubious quality; in particular, "data" is not the plural of "anecdote". I don't think your text above is neutral in any sense I'd recognise.


With the trademark penultimate sentence of an infamous British quiz show in mind, I shall deliver her final comment to a departing contestant: good-bye. From Cool Hand Luke to Martin Luther, here I stand. I can do no else. Have mercy on me.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:04, 30 October 2008 (UTC)
:: The current draft includes "the consensus of medical and scientific opinion is that homeopathy is unfounded." I think that is accurate, neutrally stated, and sufficiently direct.


::Howard, at your encouragement, I have added info about the homeopathic interview and some basic info on what a homeopath does to find the best remedy for a sick patient. [[User:Dana Ullman|Dana Ullman]] 05:06, 31 October 2008 (UTC)
:: That said, I do think we should link to highly critical articles such as that one, possibly the [http://rationalwiki.org/wiki/Homeopathy rational wiki] page, and certainly the [http://xkcd.com/765/ lovely cartoon] they use. [[User:Sandy Harris|Sandy Harris]] 07:40, 16 September 2010 (UTC)


:::Well, let's see if we can jointly improve this. Perhaps it will help if I gave one horrible medical example which, IMHO for all the wrong reasons, is going before the U.S. Supreme Court. I'll take another example or two from medicine, at least one of which is likely to be an indication that a case might be good for individualized medication.
::: See rational wiki's article "Citizendium" first. [[User:Anthony.Sebastian|Anthony.Sebastian]] 03:57, 17 September 2010 (UTC)


:::On November 3, the Supreme Court is to hear the case of ''Wyeth v. Levine''. No one will find me an apologist for pharmaceutical companies that do not document side effect, or suppress trial data. From the legal documents [blog commentary http://www.healthbeatblog.org/2008/10/the-case-of-pat.html]], I am utterly baffled about why this case is turning around a pharmaceutical company's labeling, when the drugs involved were:
== Suggest ending Main Article draft at end of lede ==
:::#Injected by an injection technique that is inherently risky and is to be reserved principally for life-threatening conditions; a migraine is not such. This is How-to-Inject-101; the actual injection was by a Physician Assistant
:::#The drugs used are old and well-known, and anyone giving them should know the risk factors. They are generic. I don't actually give them, but I knew the doses and warning from memory.
:::#This was a combination of an opioid analgesic and an antihistamine, neither of which are preferred analgesics and antihistamines. Further, if it was a true migraine, the first-line drugs are not painkillers, but triptans that bring the cause of the pain under control. There may be contraindications to triptans and this hasn't been brought out.
:::#Nothing was said about why the patient was in an ER for a migraine, but chronic headaches, especially of the migraine class, are best prevented rather than suppressed. Prevention relies on a good history, which may find a trigger to be avoided. Since the inherent mechanism is a overdilated blood vessel, many pain specialists will, possibly in conjunction with specific preventives and possibly without, may recommend meditative, biofeedback, relaxation or other alternative methods that can relax that vessel.


:::Now, individualization and listening to symptoms. As a matter of fact, I had to deal with this in a housemate yesterday. Twice in a day, she had a nosebleed, which is very unusual, but it was minor. The second time, she said she was getting a severe headache, and I '''ran''' to get a blood pressure cuff. While it is a rare event, the combination of an unusual bleed with a sudden and severe headache has to be considered a potentially immediately life-threatening hypertensive crisis with intracranial bleeding. When her blood pressure and pupillary response were normal, the next things we looked at were room humidity, air filtration, and aromatherapy, if you will, with eucalyptus oil, often safer and more effective than vasoconstrictive decongestants.
Let reader use Biblio to get further information. Concentrate on thorough Biblio subpage. 06:39, 17 September 2010 (UTC)


:::In a pain management group, the exact wording a patient uses to describe the pain can be very informative. Now, a good team agrees that whenever a patient reports distressing pain, that is real for that patient and needs to be understood. There are certain ways of describing headaches and trunk/back pain that must have critical factors ruled out; A simple, whispered, sudden "this is a terrible headache" were Franklin Roosevelt's last words; "This is the worst headache of my life" also will set off alarms. If, however, a patient uses exceptionally vivid language, such as "a thousand demons run up and down my head, stab with their pitchforks, and rub salt into the nerves", experience shows that while there may be a vary real abnormality, it's very likely that nonpharmacologic means will help reduce the long-term distress.
: I don't think that is an adequate approach for an encyclopedia. We want a reasonably detailed explanation here. That said, the article could likely be shortened significantly without losing anything valuable. [[User:Sandy Harris|Sandy Harris]] 12:14, 17 September 2010 (UTC)


:::You will see, Dana, that, other than a blood pressure, I described no diagnostic tests. I was listening for patient-reported symptoms to help guide the response. Many of the preferred responses include complementary, nonpharmacologic techniques, and, as in the court case, the preferred pharmacologic responses are preventive rather than reactive; without going into the details of prevention, I'll loosely say that most techniques, picked carefully, are stabilizing, or, if you prefer, restoring balance.
::At home much resource cost that could be going into even copy edit of other articles, articles that deal with topics that are likely to have more serious users? I'd wager that a good part of the hit count on this article is due to people at other wikis looking for controversy.


:::Now, I was able to describe this in interpersonal terms, without referring to either a neurology textbook or a repertory. Just as with the data I have from that court case, a PA made some terribly bad choices that should have been basic training.  
::That being said, I'm not sure how feasible it is under present policy. Assume three Health Sciences and Biology Editors are willing to nominate the truncated approach for Approval. Healing Arts Editors say it is not Approvable.  It would be one thing for a Mathematics Editor to question approval for a cryptographic topic written by a computers person, but we've gotten through effective collaboration among, say, Computers, Mathematics, and Military. Health Sciences and Healing Arts, among the workgroups, are the only case where we have different workgroups for fundamentally different views on the same subject area. It's a bug, not a feature; we don't have separate-but-equal Religion and Atheism workgroups. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:53, 17 September 2010 (UTC)


:::You have made the point that a homeopath listens carefully to the patient. I have just given examples of how competent medically oriented clinicians listen to the individual experience, and, after emergencies are ruled out, emphasize prevention and stabilization with nonpharmacologic and the safest pharmacologic means. That seems to me to what you describe in the homeopathic session, but there's just a list of history-taking categories and reference books. There's nothing about the cognitive process of the homeopath in assessing the patient. There's nothing about how the interaction brings out these broader aspects of how aspects of the patient's life, which are not strictly disease-oriented, are brought out &mdash; a skilled history taker can bring out things of which the patient may not be consciously aware.
== Definition ==


:::So here I am, with specific examples, presenting an integrative, using the least risky treatments including complementary methods, and in a medical setting. This seems to be much as you've described an optimal homeopathic encounter. I'm looking for equivalent homeopathic approaches, such as the way a traditional acupuncturist will try, from pulses, point sensitivity, and discussion, to identify the problems with ''chi'' flow on the classic meridians.  
The current definition reads "System of alternative medicine that asserts — contrary to scientific  evidence — that substances known to cause specific syndromes of symptoms can also, in very low and specially prepared doses, help to cure people who are ill with a similar syndrome of symptoms." I think that is a moderately awful definition. The problems I see are:
: The "contrary to scientific evidence" bit, or similar text, has been added at least twice and reverted at least once. I don't think it belongs in the definition.
: "syndrome of symptoms" is used twice. That's ghastly stylistically, "syndrome" is a technical medical term that may not belong here, and in any case, I suspect "syndrome of symptoms" is redundant. What else could you have a syndrome of? Or does a syndrome include more than just symptoms?
My version would be: A system of alternate medicine based on the idea that substances known to cause particular combinations of symptoms can, in very low and specially prepared doses, help to cure people who are ill with similar symptoms.
(sig added later [[User:Sandy Harris|Sandy Harris]] 23:14, 17 September 2010 (UTC))


:::Do you see what I am trying to get? It is fairly specific and basic, and does not need generalities about historical homeopaths, how physicians have been mean, structure of water, etc. I am a patient on a first-time meeting and I tell you I am here because I have terrible headaches that the idiot doctor couldn't cure. What happens next? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 11:58, 31 October 2008 (UTC)
""Syndrome of sympoms", indeed, is ghastly. Unfortunately, it touches on a difference between homeopathic and current medical thinking that is as important as similars. Modern physicians look first for an etiological diagnosis: what is the cause of the patient's distress? (Note here that "symptom" is being used in a lay sense here -- there are differences of theory as well). Homeopaths consider that the "disease model", not patient-centric, and often reject a causality-based approach. Their focus is on the products of the cause (in medical thinking) or the body wisdom expressing its defenses.


Howard, I simply do not see an encyclopedia become a personal health guidebook, nor should it be a review of the "cognitive processes" of a homeopath, unless you or someone wants to have a separate article on that subject (go for it, if you are seriously interested).  Our article presently provides detail enough about what a homeopath will interview the patient and what methods the homeopath will do to select a medicine individually chosen. To clarify, homeopathy is not about just "listening" to the patient (heck, if that were the primary benefit, psychologists and psychiatrists would be much more effective because they have weekly hour-long sessions with patients...and having friends would be even more therapeutic). 
:A better wording would be welcome, but the rejection of etiologic thinking, and the focus on similars as a means of reducing symptoms, is fundamental. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:53, 17 September 2010 (UTC)


If, for personal reasons, you want more information on how a homeopath would treat your headache, why don't you consider going to a homeopath (if you wish and if contact me via email, I will extend myself and make a referral to you).  Can I also ask you to try to reduce the length of your postings (the above post is a good example of something that could easily have been said in half as many words).  By the way and once again, "restoring balance" has no meaning in homeopathy. [[User:Dana Ullman|Dana Ullman]] 13:03, 31 October 2008 (UTC)
Sandy's version:
*A system of alternate medicine based on the idea that substances known to cause particular combinations of symptoms can, in very low and specially prepared doses, help to cure people who are ill with similar symptoms.


===Regretfully, I find this response evasive===
First, it's not yet "our" article, because there is nothing approaching CZ consensus. Second, there already is a [[history of homeopathy]] article. Third, there are abundant medical articles, and ones that seem to have interest, that very much deal with the cognitive processes of prevention, diagnosis, and treatment. 


I do not have a headache, although this line of discussion could give me one. I used a hypothetical example, a common and reasonable writing technique, to set a representative scenario in which an interaction could be described. You may rest assured that it is entirely irrelevant, at present, for me, to want to know how a homeopath would treat a hypothetical headache of mine, since, based on the lack of information on homeopathy presented here, I would never go to one because I have no specifics on what homeopaths actually do. Please stop attributing personal motivations; it is unprofessional at CZ.  
My understanding:
*A system of alternate medicine based on the idea that large dosages of substances known to cause particular combinations of symptoms in healthy individuals can, in very low and specially prepared doses, help to cure a person whose illness causes similar symptoms.
[[User:D. Matt Innis|D. Matt Innis]] 21:49, 17 September 2010 (UTC)


Yes, that was a lengthy post. It was lengthy because I find you nonresponsive to most questions, and I wanted to give you multiple analogies for two reasons. One is that you actually might see something that resonated as a point of departure. Two, I demonstrate that there are abundant ways of describing encounters with healthcare providers and the approach taken, except, apparently, with homeopaths.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:23, 31 October 2008 (UTC)
::I am quite willing to be corrected here, but I think the idea of an illness that creates similar symptoms is still too close to an etiologic model of disease to be accepted by homeopaths. While I don't have better words, my sense is they would say the symptoms are produced by the "wisdom of the body" as "defenses" and the remedies strengthen the defenses. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:59, 17 September 2010 (UTC)


: Just because I have a different opinion that you do on what should be in this article does not mean that I am being evasive, and I find that your decision to express your angst in headlines is quite melodramatic and not constructive.  And just because you and/or others have created a separate article on the history of homeopathy does NOT mean that there should be no history here.  In fact, your insistence and repetition on this issue is getting tiring. Sadly, I am giving you a headache, and you are giving me fatigue.  Despite our difference of opinion, we are appropriately expressing our own POV.  I am hearing you, just differing with you.  I hope that you're hearing me.


: The reason that I think that your idea of writing about the cognitive processes of a homeopath would require detailed "materia medica"* discussions of the many common medicines that homeopaths use for headaches, each known for its own certain pattern/syndrome of symptoms. Perhaps someone will want to create something like this in the future when we have many more sub-articles on homeopathy.  ("Materia medica" is Latin for the materials of medicines used in homeopathy, and this term is both used to describe a body of symptoms associated with a specific medicine, and it is a single or set of books that do this).  [[User:Dana Ullman|Dana Ullman]] 00:12, 1 November 2008 (UTC)
::: That could be the next sentence.  


::Well, we seem to be at an impasse, since your description of homeopathy seems to require it be treated differently than any other discipline. What I hear is that homeopathy, as you describe it, must be accepted on faith, and I am not willing to accept that outside a religion article. My own silly observation, from 40 years of experience in complex decision support, is that the starting point would be not the materia medica, but the metadefinition of pattern/syndrome.


::I'm really not going to engage in what I regard as pointless and circular discussion of what I believe to be reasonable encyclopedic writing requirements. I shall simply continue to edit what I believe to be attempts to suppress less than positive statements about homeopathy, and the relevant Editor or Editor in Chief will have to resolve the dilemma, if the article is ever to progress. Perhaps your becoming familiar with a few other articles, even, dare I say, in medicine or biology, might give you a better idea of expectations that are not mine alone.  
:::*A system of alternate medicine based on the idea that large dosages of substances known to cause particular combinations of symptoms in healthy individuals can, in very low and specially prepared doses, help to cure a person whose illness causes similar symptoms. In essence, they believe that symptoms are produced by the "wisdom of the body" as "defenses" and homeopathic remedies are designed to strengthen those defenses.


::You are, in my opinion after writing and editing an article or two, here and there, on CZ, expecting homeopathy to be treated differently than any other topic of which I'm aware. Eventually, you may find that it is your POV about encyclopedic standards that is more a matter of concern than the arcana of homeopathy. Until then, I say what Clark Gable said to Vivien Leigh. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:30, 1 November 2008 (UTC)
:::[[User:D. Matt Innis|D. Matt Innis]] 03:22, 18 September 2010 (UTC)


:::I earlier expressed concern that you've been melodramic lately and your reference to Clark Gable and Vivien Leigh is additional evidence of this. Of greater concern, I cannot see how or why you would say that this article is based on "faith."  If so, please show me any (!) religious article on CZ for which there is reference to numerous double-blind and placebo controlled clinical trials and basic science trials. If you cannot do so, please stop making such silly statements, and let's move towards constructive comments. That said, we all occasionally write stuff that we later regret. You can and do provide good constructive comments here. Let's get back on track. [[User:Dana Ullman|Dana Ullman]] 22:05, 1 November 2008 (UTC)
::::Add: They do not use the disease model of conventional medicine, in which there is a disease rather than an individual set of symptoms, and treatment directed at a cause of that disease as it presents in multiple patients. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:29, 18 September 2010 (UTC)
:::::More work:
:::::*This contrasts with conventional medicine's "disease model" of treatment that looks to treat the disease process and therefore relieve the symptoms.
:::::I'm not sure that's totally true, though. Many conventional treatments are directed at relieving symptoms, too.
:::::[[User:D. Matt Innis|D. Matt Innis]] 03:54, 18 September 2010 (UTC)


::::Melodrama? Ah, I shall draw from Edith Piaf, and sing, "I have no regrets" (well, if I could sing in French). My repeatedly deflected questions are not about clinical trials, but about the regular practice of homeopathy. You keep assuring me that the clinical decisionmaking cannot be explained other than by having studied the inner mysteries, and I should accept that the general practice of homeopathy works because you say it does, but you can't tell me, except in concepts, its basic practice. Well, in response to that, I respond with a reasonably decent parallel to that explanation: [[Ontological argument for the existence of God]]. No specifics, just concepts.
(edit conflict) (undent)
There's a different philosophy in symptomatic treatment. If I sprained my ankle badly enough to need surgical repair, the cause would be relevant to a conventional orthopedist who needs to work on the damaged structures. Otherwise, the exact ligament stretch might be known, but it's not of therapeutic benefit. Symptomatic pain relief is the first consideration -- yes, rehabilitation may focus on exact etiology, but, for the sake of argument, assume it's self-limiting.  


::::I would respond with inviting you to find a medical article on CZ for which an advocate repeatedly insists that the cognitive process cannot be explained. Actually, though, I think I can be even more on track with a good article on sympathetic magic, which I am writing. Some of Hahnemann's writings resonate extremely well with 150 years or so of anthropological observations of the practice of sympathetic magic. What, you say? But you use modern methods routinely now? I still haven't found out what they are in the context of a homeopath-patient encounter, yet I can easily describe them for a wide range of general and specialized medical areas and yes, even some complementary methods. As you keep saying, homeopathy has stood the test of time, and you've never rejected his language about miasms, so I see no reason not to put his theories in context. In fairness to the man, he made very wise observations given the information available at the time.  
Sometimes, as with uncomplicated childhood otitis media, even if it is bacterial, antibiotic therapy may not be justified. Presumably, though, the child can still get acetaminophen.


::::If "on track" means a song of praise of homeopathy, with "simplification" of the actual language from clinical trial abstracts that have a few more caveats than "promising", enjoy your exercise. Periodically, I shall glide by, on raptor wings, check references, and restore a bit of balance...oh, that's right.  
In both of the cases above, there was awareness of an etiology, but a choice to treat only symptoms. Palliative care is often largely but not exclusively symptomatic -- still, an etiology would be necessary for chemotherapy or radiotherapy to slow the growth of an incurable tumor. Pain management, though, is symptomatic and even more important. Where does nursing care fit?


:::::"By the way and once again, "restoring balance" has no meaning in homeopathy.  [[User:Dana Ullman|Dana Ullman]] 13:03, 31 October 2008 (UTC)"
The homeopaths, however, appear to exclude the idea of treatment based on etiology, as opposed to symptom relief when the cause is either self-limiting or not treatable. I spend hours daily giving comfort care to my cat buddy, relatively little of which is directed at the cancer itself, but much more in nutrition, emotional support and wound care. Indeed, I am using some complementary medicine along with a lot more conventional things.  Homeopathic ideas of symptom-oriented remedies don't enter into it. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:28, 18 September 2010 (UTC)


:::::My point exactly. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:32, 1 November 2008 (UTC)
: I don't think either that long definitions are a good idea in general, or that the proposed "next sentences" are needed in this definition. In the article, certainly; in the lede, probably. However, the definition needs to be short and direct. In particular, it needs to be short enough to look reasonable when cited on a related articles page. [[User:Sandy Harris|Sandy Harris]] 04:46, 18 September 2010 (UTC)


Howard, I was being diplomatic when I said that I felt you were being melodramatic. More accurately, you are too often writing meaningless stuff and providing misinformation.  I never said as you assert above, "the clinical decisionmaking cannot be explained other than by having studied the inner mysteries."  I simply said that I didn't consider this information to be appropriate for CZ and that doing so would require detailed comparisons between 2-20 (or more) medicines. Please show me where on CZ that anything like this is done, but like I said, if you want to do this, maybe you should do the research and create a sub-article on this subject.
::If the definition is to be short, then, I believe the rejection of etiology is far, far more significant to homeopathy than the better-known issues of small doses. It appears to me that Hahnemann's insight dealt with symptoms being the essential manifestation of health or not-health, and only ''then'' did he go to the idea of provings and similars. My understanding is that his using provings for malaria had to do with the symptom production of quinine.  


What I am more concerned about is that you seem to enjoy baiting me. You exaggerate what I write and do not show intellectual honesty by doing so. This is not conducive to collaboration. Even your quote about from me about "restoring balance" was my critique of some silliness that you wrote, even though you were previously informed that "restoring balance" is not a homeopathic concept. 
:::Absolutely, I forgot that we were working on the definition! You're right, Sandy. [[User:D. Matt Innis|D. Matt Innis]] 21:27, 18 September 2010 (UTC)


Although I appreciate some of what you do here (I do!), this tends to be an exception to the rule.  There is a good reason that a lot of people here do not respond to your postings; it is because they are not worthy of further discussion.  I urge you to be more selective in what you write, both in quantity and in quality. [[User:Dana Ullman|Dana Ullman]] 02:48, 2 November 2008 (UTC)
::I believe there's a comment on this page, from a homeopath, that homeopathic remedies are not always administered in homeopathic femtodoses.  


== Section moved down from above ==
::The rejection of etiology  is also key to much of the dispute with medicine, as I mentioned in terms of clinical trials. It is also, however, central to the medical rejection of some homeopathic approaches, such as the principal treatment for malaria being based on reducing ''Plasmodium'' parasites in the blood. Quinine remains a third-line drug for malaria, but its action in reducing fever and chills is due to its ability to suppress the parasites, not (in a medical view) what effects are caused by high doses of quinine. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:56, 18 September 2010 (UTC)
:::Quinine remains a third-line drug for malaria, but its action in reducing fever and chills is due to its ability to suppress the parasites, not (in a medical view) what effects are caused by high doses of quinine.


First, I shall announce that yesterday, I made the best rye bread I have ever made, which is making me feel better this morning. Alas, I know of no networking technology that can transfer fresh-baked bread.
::::I think that's the point; it's not that homeopath's don't care about etiology, they just don't concern themselves with it.  If it causes the same symptoms in a normal person, then it's used to treat the person that has those same symptoms, regardless of the cause. As you say, they might contend that the plasmodium is not what causes the symptoms, rather the symptoms are the body's response to plasmodium. To them it doesn't matter. [[User:D. Matt Innis|D. Matt Innis]] 21:28, 18 September 2010 (UTC)


Larry, apparently I misunderstood that you wanted a much more extensive "mainstream medcine" response. I read some of the homeopathic request to mean that I was being asked "go on the net" and find evidence of solid statistical methodology and results that made the response "equal" in their responses. I was also frustrated by what seemed to be, simultaneously, citing of statistics about questionable merit such as popularity and referrals, but either selectively reporting things that were there, or denying there was any way to make homeopathy compatible with mainstream standards of substantial evidence.  
:::::As my grandmother might have said, ah-HAH! Admittedly, I'm taking the example of the worst form of malaria, but a patient presenting with the cerebral form of ''[[Plasmodium falciparum]]'' malaria may well die in 18 hours. In general, the standard of medical care would be [[artemisinin|artemisinin-based combination therapy]], with [[critical care]] support for effects such as   [[acute respiratory distress syndrome]] or [[disseminated intravascular coagulation]].  


Note that last: evidence, not proof. While every field has its charlatans and outright idiots, there is a trend in medicine to have the humility to accept that diagnosis and treatment need constant revision and improvement. With essentially the same genetically related heart problems, I've outlived my father for 18 years, and he spent the last several years as a cardiac cripple. I look back to what was available at the time of his serious decline in health, and most of the relevant drug classes had not been invented.  
:::::Quinine, in substantial doses and '''in combination with''' doxycycline, tetracycline, or clindamycin, be lifesaving. If I were the patient, however, and someone offered me homeopathic oral doses of oral quinine, I'd prefer a lethal dose of barbiturates, or a large-caliber bullet to the back of the neck (messy but fast).  


I also think of some interdisciplinary medical seminars I've attended, and was fascinated to see, for example, orthopedists and chiropractor working to bring their specialized expertise to clinical problems, with both listening to an expert in pain physiology to hear techniques that could complement their work.  While I recognize there are different schools of thought in chiropractic, and $DEITY knows enough (substitute non-family-friendly term) in orthopedics, the point is that everyone was looking for, and finding, common ground. No one was saying the other field couldn't ask hard questions. Most importantly, there was an eclectic, but general consensus about using evidence, and fitting treatments to mechanisms we can always understand better.
:::::Now, I'd have every respect for a ''complementary'' homeopath that suspected severe falciparum malaria, and immediately transferred the patient to medical care. Assuming such care were available, I'd regard an ''alternative'' practitioner as having, as the lawyers put it, ''depraved indifference for human life.''.  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:02, 18 September 2010 (UTC)
:::::: I suspect the cerebral form would have different symptoms, therefore different remedies as well. A bullet is probably not one of them. ;-) [[User:D. Matt Innis|D. Matt Innis]] 23:40, 19 September 2010 (UTC)


Contrasting those workshops with the discussion here simply makes me sad. Oh, there's no question that someone may offer an aphorism, about the clinical encounter, from Osler, but no one is stuck in the professional jealousies and defensiveness of 100 to 200 years ago.  While this article clearly needs some historical context, some of the most bitter statements, as well as quotes justifying homeopathic positions, are over a century old &mdash; sometimes two. Let the material about the early homeopathic and medical squabbles move to [[History of Homeopathy]]. Include enough history to understand terminology (and there's the "catalog"), but concentrate on current work. I would be delighted to explain how bad conventional medicine was at the time of Hahnemann. A century later, Osler observed that there were principally two drugs that consistently did something (digitalis and morphine), with roughly ten more that have stood the test of time. I take a sometimes daunting range of medications for the same diseases as my father, but, running through the list mentally, as many as 12 didn't yet exist at the time of his death. How often are new homeopathic methods demonstrated?  How often are things added to ''materia medica''? When do homeopaths remove remedies from use because they have been demonstrated to be unsafe (including avoiding effective non-homeopathic treatment) or to be ineffective?
:::::::Are you doubting the efficacy of a .45 caliber ACP 254-grain round, which is lead in a hardly homeopathic dose?  Nevertheless, if I had cerebral P. falciparum malaria, I know that active medical treatment is still very iffy. Seriously, we have the problem of any validation here; I cannot imagine an ethics review board that would approve any treatment for such a life-threatening disease without overwhelming laboratory evidence for the control arm. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:21, 20 September 2010 (UTC)


There is almost nothing in the article about homeopathy as complementary medicine; there is a great deal about homeopathy as an alternative to mainstream medicine. There are some awfully vague comments about using medical testing and diagnosis, but I am still completely bewildered by how the disciplines can work together. At the same time, I have both personal and scientific exposure to very effective collaborations between mainstream and complementary practitioner.
===Sandy's edit to the definition===
...specifically "help to cure or prevent  illnesses involving similar symptoms."  While a homeopath will have to review this, I don't think "illnesses involving similar symptoms" is really a homeopathic concept. They certainly object to "diseases with similar symptoms", and tend to reject "disease" as a medical conceit. The symptoms are signals of the body's defenses to be strengthened, not the effects of a causative factor. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:59, 18 September 2010 (UTC)


:I have occasionally made errors, and when it is noted, I acknowledge it.  We all make errors.  I sincerely hope that Howard will acknowledge this error below. Ramanand above noted, This article should be <blockquote>about what homeopathy '''is''', rather than how it is criticized.</blockquote>. I'm wondering what was wrong with <blockquote>Homeopaths counter that the vast majority of these larger trials tested a single remedy given to every patient without any individualized treatment, suggesting that these larger trials did not maintain external validity to the system of homeopathy and are therefore not valid tests of it.</blockquote>which Dana had inserted.
: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)


:Howard then responded, "What is wrong? It says, in very, very general, nonquantitative terms, that homeopaths don't like trials. It doesn't say how homeopathy can be validated beyond "trust me".
:Sandy's new definition is definitely an improvement. [[User:D. Matt Innis|D. Matt Innis]] 21:32, 18 September 2010 (UTC)


:My concern here is that Howard doesn't seem to understand what is meant by "external validity," which is an important statistical concept.  The test of one homeopathic medicine in the treatment of a condition for which it is rarely, if ever, used is NOT a good, adequate, or "scientific" test of homeopathy or the homeopathic method.  The Shang analysis actually included one trial on the use of Thyroidinum in the treatment of "weight-loss."  This study had no external validity.  Likewise, Shang analysis included tests of Oscillococcinum in the PREVENTION of the flu...as well as a separate inclusion of a study of Oscillococcinum in the TREATMENT of the flu.  There is a long history of use and success in using Oscillo in the treatment but NOT the prevention of the flu. A competitor (Dolisos, Inc.) to the makers of Oscillo in France funded the prevention study, which again, had no external validity.  It was no big surprise to find out that this medicine didn't prevent the flu.
::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>
:::The matter in brackets is optional.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:36, 19 September 2010 (UTC)
:::Note that it is '''alternative medicine''' and not '''alternate medicine'''.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:44, 19 September 2010 (UTC)


:These poor scientific studies are akin to prescribing antibiotics for viral infections and then asserting that "antibiotics do not work for infections." That statement is misinformation.
::::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]].  


:Ultimately, there are rare instances where one homeopathic medicine can be successfully prescribed to people with the same disease, though most of the time, effective homeopathic treatment requires individualized treatment. In sum, Howard, I certainly didn't say or infer that homeopaths do not "like trials" (we just don't like poorly designed trials that are set up to not adequately test homeopathy). [[User:Dana Ullman|Dana Ullman]] 16:51, 21 October 2008 (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.  


::Dana, I agree that a specific trial should only be testing the homeopathic remedy for which it is designed, but it is still not clear to me whether this precludes clinical trials or not? Obviously precribing is highly individualistic so this make selecting the patients for a trial more problematic. Are there any cases of trials that have occurred where a homeopath does control the remedy but it is also blind from the perspective of the homeopath and the patients?  And this comes to another issues that i have still not really wrapped my mind around.  If everything is so individialised how is it possible to have homeopathic remedies available for sale from a store?  I just can't understand how remedies are robust enough to be sold from the shelf yet a population of patients cannot be found that that all use the same remedy in a blind clinical trial. [[User:Chris Day|Chris Day]] 17:25, 21 October 2008 (UTC)
:::Please confirm or correct the statement that homeopaths do not believe in the concept of disease, in the sense that disease has an etiologic cause and the cause needs to be corrected. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 08:30, 19 September 2010 (UTC)


::Any thoughts on these questions? [[User:Chris Day|Chris Day]] 17:06, 26 October 2008 (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)


:::Any thoughts? [[User:Chris Day|Chris Day]] 16:02, 30 October 2008 (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)
 
As for Chris' questions about good blinded trials in homeopathy that are respectful of the homeopathic method.  Absolutely!  The Jacobs' diarrhea trials, the Chapman mild traumatic head injury study, there have been a couple ADD/ADHD trials, a study at the University of Vienna Hospital on severe sepsis (individualized homeopathic treatment led to a 50% reduction in mortality as compared to patients given a placebo!)...and many others.  There was even an interesting asthma trial that gave potentized doses of whatever the patients was most allergic, based on conventional allergy testing...with the medicine being a potentized dose of the allergen. 
 
It is interesting that Howard seems to think that it has been conventional medicine that has helped him outlive his father (who seemingly had a similar ailment as he has), when, in fact, Howard also acknowledges that he has used acupuncture, chiropractic, and perhaps other treatments which also may have changed his health status.  Good for him in any case.
 
I'm confused by a lot of the above...but there is one part above that is WRONG.  Homeopaths have no problem with scientific investigations/trials, but we just don't like trials that are poorly designed and that do not adequately respect the homeopathic method.  I'm sure that Howard and Chris would not like a trial that tested an antibiotic in the treatment of a viral infection, especially if its negative result leads anyone to conclude that this antibiotic is ineffective for "infections."  Similarly, one cannot simply give ONE homeopathic medicine to everyone with a specific disease (except in rare exceptions, which I have in part given previously). 
 
I do need to say that I am surprised, even shocked, that Howard seems to believe that physicians today are humble (his word was having "humility").  While I certainly agree that some docs are humble, they are rare.  More often, they are extremely arrogant, and worse, they are extremely antagonistic when patients have an interest in unconventional treatments (several studies have shown that 70% (!) of patients who use alternative therapies do not tell their doctors about it...ouch).  While this antagonism has diminished recently, the arrogance of doctors is normalcy (sad but true).  I am not saying this to attack docs.  I am reporting the state of medicine today.  I see much much more humility from homeopaths and alternative practitioners than from conventional docs, though there are exceptions on both and all sides (of course).  [[User:Dana Ullman|Dana Ullman]] 00:23, 31 October 2008 (UTC)
 
== Deletions of commentary unrelated to specific cited material. ==
 
There can certainly be comments of homeopathic opinion, but not in a place that would suggest they are part of the citation. In the first cut below, I removed the struck-through text, because it was an apparent individual comment of emphasis, not related to the citation. The citation has been "nowiki'ed" so the context can be seen.
*Begin text from article
Homeopaths also cite a study where "a homeopathic remedy" has been used to shorten the duration of acute bronchitis<nowiki><ref>{{citation
| journal = Phytomedicine
| date = 2008 May
| volume = 15(5)
| pages = 378-85.  
| title =Pelargonium sidoides for acute bronchitis: a systematic review and meta-analysis.
| author =  Agbabiaka TB, Guo R, Ernst E.
| url = http://www.ncbi.nlm.nih.gov/pubmed/18222667
}}</ref></nowiki><s>and thereby heal a patient</s>.
:'''when an attack is shortened, it will heal.'''&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:25, 3 November 2008 (UTC)
*this article does not include the word "homeopathy", so it cannot be inferred whether it was, or was not, used in homeopathic therapy, without further citation from the article. I inserted what I believe to be accurate compromise text:
::'''it does in the body, so I've inserted that.'''&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:25, 3 November 2008 (UTC)
Concentrated plant extracts may be used as mother tinctures, or the starting point for dilution, but such use is not mentioned in the ''Phytomedicine'' article. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:59, 2 November 2008 (UTC)
 
*Again, I show, with strikethrough below, text about homeopathic positions that was inserted into a specific statement of medical principles. Whether or not individualized remedy selection is a must in homeopathy is irrelevant to a specific statement, with supporting station, about what conventional medicine does.
 
Conventional medicine also has consistent clinical and pathological definitions of asthma, with considerable customization for individual patient needs but still enough common criteria to allow significant retrospective analysis in large populations<nowiki><ref name="NAEP">{{citation
| author=National Asthma Education and Prevention Program
| title = Expert Panel Report III: Guidelines for the diagnosis and management of asthma| publisher =  National Heart, Lung, and Blood Institute, 2007. |id = NIH publication no. 08-4051
| url = http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm}}</ref></nowiki>; <s>which is because individualised remedy selection is a must in homeopathy.</s>
::'''that was a grammatical and syntax error which I've set right.'''&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:25, 3 November 2008 (UTC)
*Further, I deleted ", but this article has references to studies/trials which show homeopathy is effective." from the simple footnote defining a term of art, not arguing about it. To me, it's useful and neutral to know that homeopaths use "remedy" as a specific term; in this context, it's roughly equivalent to say that conventional physicians write "prescriptions", which is a term of art in conventional medicine.
 
[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:19, 2 November 2008 (UTC)
::'''the article does mention positive studies, so your removing that is against the ground rules.'''&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:21, 3 November 2008 (UTC)
 
::I don't really plan to argue with you, but simply to pass this to Larry Sanger, and perhaps he can explain it in a manner you will understand. The ground rules do not allow you to insert homeopathy-positive phrases into the middle of text that is simply defining a term, or is presenting a negative medical analysis. They do allow you to write a clear statement of homeopathic position before or after it.
 
::Note that I said "present". CZ editorial rules do not allow arguments in the text. Opposing views can be presented and let the reader judge. You may not attack a medical position, but you may include appropriately sourced homeopathic positions near it, in a grammatically reasonable way. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:39, 3 November 2008 (UTC)
 
:::Well, you did not provide sources for those comments (I can provide sources for my comments, but I don't have the time just now).&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:51, 3 November 2008 (UTC)
 
== Mistaken deletion? ==
It was not my intent to do anything more than a minor edit, but somehow Howard correctly did an UNDO on what seems to have been a mistaken deletion of a large body of text.  Thanx Howard.  Before going to constabilary route, in the future you might check-in with me (or whoever the person was who seemingly did a large delete).  [[User:Dana Ullman|Dana Ullman]] 19:24, 2 November 2008 (UTC)
 
:Or might not, when it immediately follows what I now regard as a completely failed attempt at collaboration, and results in 80K in deletion, which is very hard to consider an accident. Oh, I've accidentally made such deletions, but immediately saw them and fixed them.
 
:Essentially, until there is an active editor involved again, I have given up trying to discuss matters on the talk page. There are fundamental difference not simply about the subject matter, but on the nature of a reasonable encyclopedia article. I see no further point to discussion, although I will follow the rules and make a straightforward explanation, for the record, of why I made other than typographical edits. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:38, 2 November 2008 (UTC)
 
Howard, first, I had NO idea of any large deletion of mine until I noticed your edit...and I immediately thanked you for that.  I had no reason to do that deletion on purpose.  As for your desire for an "active editor," actually, I have never "pulled rank" previously, but I guess that you have not yet noticed that I am an editor (Larry Sanger deemed me such).  I haven't pulled rank because I prefer to work in a collaborative fashion...and still do.  Finally, your statement above shows bad faith, and I sincerely hope that you will redirect your energies or consider working on other articles.  [[User:Dana Ullman|Dana Ullman]] 03:43, 3 November 2008 (UTC)
 
== How about a break? ==
 
I believe we all need a longish cool-down period on this article.  I think that a break of two weeks would give all of the participants enough time to get some much-needed perspective.  Moreover, you can use your wonderful energy on an article ''other'' than this one--how great would that be?  So, unless there are any objections, I would like to ask, not require, that the participants here just drop things as they are now and return on November 16. --[[User:Larry Sanger|Larry Sanger]] 03:50, 3 November 2008 (UTC)
 
:Sounds good to me. I certainly have a few other articles, here and there, to which I might contribute.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:52, 3 November 2008 (UTC)
 
Ramanand, I'm hoping you read this--did you see the above?  Do you not agree to a time out/cooling off period? --[[User:Larry Sanger|Larry Sanger]] 02:48, 7 November 2008 (UTC)
 
:Larry, I agree completely. I was making some minor edits, but if that is not O.K. with you, I'll lay off till the 17th. I'm sorry if I offended you.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 02:53, 7 November 2008 (UTC)

Latest revision as of 16:21, 20 September 2010

This article is developed but not approved.
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APPROVED Version 1.1

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

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

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

Beginning with semi-lower-case editorial...

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

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

A balanced blog post on the subject

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

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

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

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


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

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

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

Ramanand's changes

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

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

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

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

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

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

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

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

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

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

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

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

British House of Commons Science and Technology Committee report

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

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

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

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

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

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

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

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

’

From the full report the committee also stated:

‘

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

’

In conclusion the chairman of the committee said:

‘

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

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

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

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

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

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

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

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

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

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

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

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

Sources

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

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

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

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

The memory of sugar

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

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

How well does it work?

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

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

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

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

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

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

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

Unsupported assertions

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

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

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

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

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

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

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

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

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

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

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

I'd suggest the following list of questions:

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

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

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

Luc Montagnier

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

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

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

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

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

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


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

Evidence that homeopathy works

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

the word "skeptic"

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

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

What the...?

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

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

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

principle of infintesimals

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

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

(undent) Please do not use color for emphasis.

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

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

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

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

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

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

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

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

Allopathy

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

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

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

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

Ruling needed

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

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

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

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

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

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

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

Matt's reversions

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

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

"Attack piece"

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

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

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

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

Similars and "allopathic drugs"

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

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

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

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

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

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

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

Dead link

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

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

Thankless CZ

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

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

Confusing deletions

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

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

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

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

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

Dana Ullman's thoughts on this article to date

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

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

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

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

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

Dana on 3rd paragraph

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

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

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

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

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

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

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

4th paragraph

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

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

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

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

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

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


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

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

Rest of article

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Logical fallacies

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

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

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

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

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

Regarding 'point of view'

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

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

Biology-Health Sciences Editor ruling needed

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

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

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

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

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

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

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

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

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

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

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

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

Followup on Anthony's comment about alternative medicine

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

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

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

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

Encyclopedia Britannica Online: Homeopathy lede

Possibly of interest:

"Homeopathy"

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

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

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

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

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

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

"Alternative Medicine and the Laws of Physics"

Of possible interest:

Alternative Medicine and the Laws of Physics

Robert L. Park

Skeptical Inquirer, Volume 21.5, September / October 1997

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

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

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

Suggest ending Main Article draft at end of lede

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

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

Definition

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

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

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

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

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

Sandy's version:

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


My understanding:

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

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

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


That could be the next sentence.


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

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

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

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

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

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

Sandy's edit to the definition

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

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

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

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

What about

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

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

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