Talk:Homeopathy/Archive 13

Homeopathy

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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.

. . "

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.

"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)