Talk:Homeopathy/Archive 13

Further categories added

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

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

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

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

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

A proposal that will, no doubt, cause consternation

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Removal of para

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

To lede?

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

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

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

First, the paragraph now in the lede,

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

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

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

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

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

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

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

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

Odd sentence

The lede contains the sentence:

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

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

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

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

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

Weasel wording in the last section, "Safety"

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

Moves to History of Homeopathy

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

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

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

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

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

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

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

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

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

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

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

I think it was Pierre-Alain Gouanvic who was keen to insert this. I inserted some of the second para as an explanation of tolerance in that context, I think there was discussion of desensitisation which I think Dana argued on the Talk page as an example of use of like cures like, and the insertaion on desensitisation was a summary of the outcome of that discussion.Gareth Leng 16:07, 23 May 2009 (UTC)

Without some serious referencing, rather than some original hypotheses, it should go, not even in history. Howard C. Berkowitz 16:15, 23 May 2009 (UTC)

Repetitiveness

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

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

Retitled section

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

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

Ortho-para water

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

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

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

First paragraph

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

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

My proposed revision is:

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

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

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

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

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

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

...particularly in the West

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

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

I haven't been able to find these figures. There's an interesting article in BMJ that estimates one-year prevalence of CAM use in various countries as of 2000,[4] but homeopathy is only one part of CAM.

I wish Homeopathy stated where those numbers came from. While Wikipedia uses far too many references, I often think Citizendium uses too few. But that's another conversation for another day.

In any event I'm going to stop editing the article for a while so it will be stable enough for the approvals manager to have a look at it. Raymond Arritt 04:01, 18 May 2009 (UTC)

I found in Ref. [36] of the draft (BMJ 1994;309:107-111 Education and debate. Medicine in Europe: Complementary medicine in Europe by Peter Fisher and Adam Ward):

Over a third of France's 54500 general practitioners use complementary methods: 5% exclusively, 21% often, and 73% occasionally.

and:

In the Netherlands 47% of general practitioners use complementary therapeutic methods, most commonly homoeopathy (40%); 9% use manipulation and 4% acupuncture. Manipulation and acupuncture are more commonly used by health professionals other than doctors and by non-medically qualified practitioners. In Germany 77% of pain clinics use acupuncture,11 and up to 37% of British general practitioners use homoeopathy

The draft refers to [36] with the sentence

In some countries, all (or virtually all) professionals that use homeopathic treatments are MDs (such as France, Spain, Argentina, Colombia)[36].

I read and searched Ref. [36], Argentina and Colombia are not mentioned at all. About France and Spain the following is stated:

In most member states of the European Union, including Belgium, France, Spain, Italy, and Greece, the practice of medicine, except by statutorily recognised health professionals, is illegal.

Further Ref. [36] states:

It [an EU proposal] also demanded an end to prosecutions of non-medically qualified practitioners in countries such as France and Spain, and for a pan-European system of regulation of non-medically qualified practitioners along the lines of the British Osteopaths Bill.

To conclude from these sentences that "all professionals in France, Spain, Argentina, Colombia using homeopathy are MDs" is stretching Ref. [36] further than I believe is honest. This makes me wonder: how relevant/pertinent/accurate are the other references in the draft?

--Paul Wormer 09:40, 18 May 2009 (UTC)

Thanks for tracking all of that stuff down! I remember, months ago, that Dana kept putting this stuff in and other people kept trying to modify it. Could you now make some sort of decision about what to do with it all? Thanks! Hayford Peirce 17:24, 18 May 2009 (UTC)

It's probably worth asking for the purpose of the material. I have no objection to saying that some people and cultures, more than others, like homeopathy. There seemed an effort, at times, to push homeopathy both by endorsements and numbers, or by citing work by physicians who had done both homeopathic and non-homeopathic things, but only citing the former.

One claim was made that homeopathy was the third most common form of alternative medicine, and I did a little calculation given the numbers of homeopaths and the claimed number of patients. Poor fellows would have needed to see around 1000 patients a day to keep up the encounter lengths.

It's one thing to say a physician uses homeopathy at all, and another thing to say a physician endorses homeopathy. Just as physicians, in the U.S., inappropriately use antibiotics due to patient pressure, I wonder how many European physicians use homeopathic preparations due to patient pressure. Oscillococcinum seems widely used. Actually, I saw it in a U.S. drugstore, prominently advertised, and could not help but think of the sound made by its principal ingredient (when alive). Howard C. Berkowitz 17:51, 18 May 2009 (UTC)

Reapproval?

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

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

Text in footnotes

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

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

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

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

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

Confused on source

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

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

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

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

No, that's not plausible. I suspect "genetic history" should be "family history" (see e.g., here[5]).Raymond Arritt 03:45, 16 May 2009 (UTC)

Causes of disease

While I agree the rewrite involving vital force improved the text, we can't ignore that homeopathy really does reject the theory of a disease etiology, such as disease being caused by a pathogenic organism, and appropriate treatment to kill that pathogen. Their main model is to strengthen vital force so that the body, perhaps through immune response, kills the pathogen. An antibiotic, however, is outside their model unless, perhaps, it produces the disease effect in provings. Howard C. Berkowitz 21:01, 16 May 2009 (UTC)

Support among medical doctors

Wearing a homeopath's cap I tried to find some numbers in the literature for support of homeopathy among MD's. So far I came up with the following:

---

In the USA there is some support for homeopathic medicine among physicians. One survey¹ found that 39% of the faculty of a medical school for primary care physicians considered use of homeopathic medicine legitimate, although only 8% had personal experience with such medicine. A survey of physicians representing a broad variety of specialties in a mid-sized southeastern US city found² that 17% of the respondents considered homeopathy legitimate medical practice, but only 1.4% of the respondents had actually prescribed such medicine.

References
1. S. M. Levine, M. L. Weber-Levine, and R. M. Mayberry, Complementary and Alternative Medical Practices: Training, Experience, and Attitudes of a Primary Care Medical School Faculty, J. Am. Board Fam. Pract. vol. 16, pp. 318–26 (2003)

2. J. Jump, L. Yarbrough, S. Kilpatrick, and T. Cable Physicians’ attitudes toward complementary and alternative medicine, Integrative Medicine, Vol. 1, pp. 149–153, (1998)

---

Apart from the low percentages of MD's that actually used homeopathic medicine, our homeopath friends won't object against including these numbers in the article, I guess. For the sake of objectivity I will look further.

--Paul Wormer 12:13, 19 May 2009 (UTC)

I checked the literature somewhat further and could not find any other numbers than the ones I quoted above. A long time ago I added a number to the article that has been removed in the meantime. This is Knipschild et al. who found that about 45% of the Dutch GP's thinks that homoeopathic remedies are efficacious in the treatment of upper respiratory tract infections or hay fever. For chronic joint problems this is 30%. The article by Knipschild et al. is famous, I see it referenced over and over again.

I hope that our homeopathic colleagues will come up with one or more references to back up their claims, if not --and let's wait a while-- we will have to do some rewriting without them on basis of Fisher & Ward, the two references about the US situation, and Knipschild et al. about Dutch GPs.

--Paul Wormer 14:17, 19 May 2009 (UTC)

Use of homeopathy by MDs

Looking for recent objective assessment of the attitudes of practising physicians to homeopathy I found This survey in Germany which reported responses indicating that about 50% of respondents (GP physicians in Germany) judged homeopathy to be “rather credible”, 6% used it “very often” and another 32% “at times”. This seems consistent with the high rate of use of homeopathy by MDs in Germany reported elsewhere. Thus for example this study reported that Paediatric homoeopathy is quite popular in Germany, particularly among children from families with a higher socioeconomic status, and found that “Almost half of homoeopathic preparations were obtained by prescriptions either from medical doctors (25.7%) or from Heilpraktiker (nonmedical practitioners) (23.1%), while one-third of them were bought as OTC drugs (Paediatric homoeopathy in Germany: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS).Du Y, Knopf H (2009) Pharmacoepidemiol Drug Saf 18:370-9. PMID 19235777

A 2009 study by Münstedt K et al. in Forsch Komplementmed PMID 19420957 aimed to assess the use of complementary and alternative medicine (CAM) methods in German departments of obstetrics. ..” The most commonly used CAM therapy was acupuncture (available in 97.3% (366/376) of departments) followed by homeopathy (offered in 93.4%)”

On use in India, its been the subject of a special report in the Lancet (Prasad R (2007) Homoeopathy booming in India. LancetNov 17;370(9600):1679-80. PMID 18035598 ("In India, where homoeopathy is a national medical system, the market is growing at 25% a year, and more than 100 million people depend solely on this form of therapy for their health care")

[6]

The Faculty of Homeopathy in the UK was incorporated by an Act of Parliament in 1950. which gave the Faculty a role in regulating the education, training and practice of homeopathy by the medical profession, and gives details of GPs who provide homeopathy

In Europe, homeopathy is probably strongest in France, where two of the major manufacturers of homeopathic pharmaceuticals, Boiron and Dolisos, are located; homeopathic remedies prescribed by MDs are (partially) reimbursed by the State Medical system, and seem to be[ http://www.boiron.com/en/htm/01_homeo_aujourdhui/realite_eco_homeo.htmquite commonly prescribed there]. The second largest market is Germany.

There've been older surveys by the AMA of CAM use by family practitioners in the USA, must be somewhere in the history of the article. When I fisrt looked into it I recall I was very surprised by how many GPs were willing to refer patients to homeopaths or prescribe homeopathic remedies themselves. The impression I got was that most family doctors were quite relaxed about it.Gareth Leng 09:35, 22 May 2009 (UTC)

We didn't hear from Dana and Ramanand during this revision discussion, but it seems to me that we have now enough material to write honestly and well-documented about the use of homeopathy by physicians, even without them. What do you think?--Paul Wormer 10:28, 22 May 2009 (UTC)

Well I trawled through PubMed and don't think I've missed anything recent at least. I think there's enough here to provide an objective documentation, so I suggest you just go aheadGareth Leng 13:14, 22 May 2009 (UTC)

I edited in your references and a few others I found. I tried to reproduce the numbers that I found in the references as factually as possible (with the risk of being accused of "fringeness") --Paul Wormer 09:46, 26 May 2009 (UTC)

Essential point

Dilution often continues to the point where none of the original substance remains in the remedy. is essential but incomplete. I believe it is correct to say that homeopaths believe the "remedy" need not have any of the original "substance"; the usable remedy is modified water (or other vehicle).

Perhaps analogies help. In mechanical engineering/manufacturing, a template or jig is essential to making the desired part, but it no longer is present in the part. In various chemical syntheses, precursors are essential but no longer present. The analogies get more strained when thinking of things like primers in polymerase chain reaction, or antigens in medical remedies that work by passive immunization -- providing antibodies.

The key difference, of course, is that in each one of the analogies, we can reasonably well trace the relationship from the substance to the final product, and how the product works. In homeopathy, we get to the classic line "and here a miracle happens", whether it be memory of water, etc. Howard C. Berkowitz 15:55, 22 May 2009 (UTC)

The essential unbelievable point is that water is a liquid. For solids memory is well documented and usually called hysteresis in science. There is magnetic hysteresis and form hysteresis. Use of plaster models in art goes back to antiquity.--Paul Wormer 16:14, 22 May 2009 (UTC)

Perhaps it may not be the best example, but there's an old electronic engineering lab practical joke -- throw a charged electrolytic capacitor to someone and say "CATCH"! On a more routine basis, if one wishes to be an old engineer, one takes great precautions with high-voltage systems that are not "on".

How do we, succinctly and vividly, make this point about liquid in the context of homeopathy? Howard C. Berkowitz 16:28, 22 May 2009 (UTC)

Because I'm not a physicist I have no reason to know that it's not credible that water may have something analagous to hysteresis in aspects of its structure (of course I'm happy to accept this is so). What I find not credible is that we have could have evolved a mechanism to recognise and respond adaptively to differences in water structure. So for me, it's by the way whether water has a memory or not. Gareth Leng 14:04, 23 May 2009 (UTC)

size of atoms

I don't know who entered the statement about Loschmidt and the size of atoms, but I liked the sentence because after the size of atoms (or, as we say now, molecules) was determined, it became clear that matter is not continuous, not infinitely divisible, and not infinitely dilutable. Loschmidt was the first to give an estimate of Avogadro's number and Avogadro's number is crucial, of course, in the discussion. Maybe we should write something like: "after it was established by Loschmidt in 1865 that a given volume of matter consists of a finite, albeit large, number of molecules, it became clear that a finite volume of solvent cannot be diluted infinitely." What do you think Raymond? --Paul Wormer 14:38, 23 May 2009 (UTC)

That's fine. It captures the important point, which is that matter is not infinitely divisible. Whether the size of the indivisible chunks is 10^-11 m or 10^-10 m or whatever doesn't seem relevant here. Raymond Arritt 14:54, 23 May 2009 (UTC)

Re section on conflict with conventional medicine

I read that section as delivering largely a point of view, and somewhat selective in its negative implications of conventional medicine. Anthony.Sebastian 01:20, 25 May 2009 (UTC)

Anthony, what keeps you? You can adapt the text of the draft, as long as you are fair to homeopathy (and to conventional medicine as well, of course).--Paul Wormer 16:16, 25 May 2009 (UTC)

I think Paul meant to type "you can EDIT the text", but I won't edit his own text, hehe. Hayford Peirce 16:21, 25 May 2009 (UTC)

I know nothing, I'm a foreigner, I don't even know what is wrong with "adapt".--Paul Wormer 16:39, 25 May 2009 (UTC)

I sure wish that my French was one-tenth as good as your English! But in this case, "adapt" would mean that he is copying, and then possibly changing, the text in question for some private use of his own, not just changing the text that everyone else can see. Hayford Peirce 16:46, 25 May 2009 (UTC)

Reapproval

To me it is important that Dana Ullman is willing to approve the revised version. We tried hard to be unbiased and I hope that Dana indeed reads it that way, which would mean that we have succeeded in writing a balanced article.

Somebody put the chemistry category to this article, which implies that formally I could be an approving editor, but I would prefer that editors from health science (or whatever it is called) approve it, as the article contains little chemistry. --Paul Wormer 14:29, 27 May 2009 (UTC)

I do not agree that it is important for Dana Ullman or any other particular individual to approve the article. We should adhere to the stated approval process without deferring to any specific person. Raymond Arritt 15:40, 27 May 2009 (UTC)

Seconded. John Stephenson 10:14, 28 May 2009 (UTC)

Seems to me you've done a fine job here, conscientiously neutral, and the re-ordering works for me. I don't see anything lost that I'd worry about, the simplifying is good as is avoiding redundant adjectives. You've removed some text that was intended to emphasise the non-dogmatic and open nature of science, and that's fine, I don't think it was really needed because the article doesn't read like a lecture, which was something I was overanxious to avoid. I'm happy to support reapproval. I think Dana should be alerted and like Paul, I hope he will also find it an improvement. Dana has been a conscientious supporter of honest efforts at balance and neutrality here.Gareth Leng 13:03, 28 May 2009 (UTC)

First, I agree that the Approval process should not depend on a single person. Even if Dana were not available, it's not unprecedented to get external reviews from a non-citizen expert, which can guide one or more Editors with some expertise.

Gareth, have you considered writing an essay on that non-dogmatic position of science, especially vis-a-vis what may be considered fringe assertions, and creating it as a Signed Article to which multiple articles can link? It's not quite a policy statement, but neither is it specific content to articles where I've seen variants on it. Howard C. Berkowitz 15:35, 28 May 2009 (UTC)

[unindent] I don't want Dana to approve the draft as a person, but as a homeopath. It is easy enough to write about homeopathy in a manner that all non-believers will nod and agree that it is a good piece of work. It is much more difficult to have both parties agree that the work is honest and balanced. How do we know that the point of view of homeopaths is represented fairly and squarely other than by approval of a representative of the homeopathic community? --Paul Wormer 16:13, 28 May 2009 (UTC)

We should of course give due consideration to whatever points Dana might raise with respect to the draft. In any event I hope that a new draft can be approved in some form. As a physical scientist I cannot help but wince when reading the "Scientific basis of homeopathy" section in the approved article. Citizendium's aspirations toward being recognized as "reliable and of world class quality" are not furthered by having such material in one of its articles, much less an approved article. Raymond Arritt 01:49, 30 May 2009 (UTC)

I left a short note for him asking him to stop by if he has a chance. --Joe (Approvals Manager) 02:20, 30 May 2009 (UTC)

(undent) I haven't been able to look over all the changes, but from what I've seen so far, it looks good to me. I'm not comfortable with the lead yet, though. Comparing the lead from the approved version to the draft, I'm not sure it is an improvment from a copyedit perspective. I think we can probably clean it up some. For example, we use the word 'akin' twice. Our first sentence seems to put the skeptical view before the horse. We appear to be discounting the practice before we even define it. Anyone have an issue with me removing it to the end of the fourth paragraph moving it? This is what we have now:

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

• This is what I changed. Feel free to revert).

D. Matt Innis 04:08, 30 May 2009 (UTC)

Looks OK to me. A minor point, "utilize" is one of my pet peeves -- I tell my students to program the AutoCorrect function in their word processor to replace "utilize" or "utilization" with "use." ("Utilize" does have a use, though it's almost always used as a stilted form of "use.") But that's just me being obsessive; your overall restructuring is fine. (And I'll defer to whatever Hayford says about "utilize"... ;-) Raymond Arritt 04:10, 30 May 2009 (UTC)