Talk:Homeopathy/Archive 13

'Mad' Ennis
Should'nt we have a bit on this?

MADELEINE Ennis, a pharmacologist at Queen's University, Belfast, was the scourge of homeopathy. She railed against its claims that a chemical remedy could be diluted to the point where a sample was unlikely to contain a single molecule of anything but water, and yet still have a healing effect. Until, that is, she set out to prove once and for all that homeopathy was bunkum. Ennis and her team found that ultra-dilute solutions of histamine – so dilute that they probably didn't contain a single histamine molecule – worked on the human body just like histamine. The study, replicated in four different labs, forced Ennis to admit that something inexplicable is going on with homeopathy. And now some eminent chemists are weighing into the debate, claiming that our “understanding” of the properties of water is based on false assumptions: water, they say, has such peculiar quantum mechanical properties that we really do need to go back to the drawing board when it comes to our understanding of this root of life.


 * As a chemist who (co)authored some papers on the quantum mechanical properties of water, I'm naturally interested in the names of the eminent chemists  who are weighing into the debate and also where this debate is taking place. Thank you in advance for your giving me the names and place(s). --Paul Wormer 10:25, 2 December 2008 (UTC)

[summarised from '13 Things that Don't Make Sense', (2008) by Michael Brooks]

I see the 'other place' mentions Ennis but dismisses her research in line with the BBC's 'debunking'. Brooks is linked to the BBC.

I read an article 'somewhere' about two weeks ago on good, solid evidence of 'memory' in liquids - but blow me - now I can't find it!

Martin Cohen 17:22, 30 November 2008 (UTC)


 * Welcome Martin!
 * Yes, Ennis' work IS important for several reasons. First, initially, she was a skeptic.  Second, her study was replicated by 3 other university laboratories.  And NO (!), her work was NOT debunked by the BBC or ABC News.  For details about this "TV junk science," read Ennis' letter to me about how different this tv "study" was from hers:  http://www.homeopathic.com/articles/view,55  and see also http://www.homeopathic.com/articles/view,58
 * As for articles on the memory of water in liquid, there are several good articles, though I am not certain to which you refer. I am certain that you will find whatever you may want on THIS subject here at the site of Professor Martin Chaplin:  http://www.lsbu.ac.uk/water/memory.html  Dana Ullman 17:55, 30 November 2008 (UTC)


 * This work is already covered in Memory of waterGareth Leng 13:06, 1 December 2008 (UTC)

Net problems
Hit technical problems at the weekend - first CZ went down here just as I was starting, then my net service went down, so apologies - I'd scarcely begun; I'll get vback when I can but life is now tight for the next week or so. However, the article is too large in my view and I'd suggest moving the bulk of material on the efficacy into a focussed article on Testing the efficacy of homeopathy. Comments?Gareth Leng 13:04, 1 December 2008 (UTC)

Hi Gareth (and everybody), whenever CZ goes down, please send me an e-mail ASAP. Often I'm the only person available who can do anything about the problem, and while I typically visit CZ several times a day, there are often gaps of many hours... --Larry Sanger 14:41, 1 December 2008 (UTC)

Gareth's extensive editing
A very nice job! As you know, I had given up on this article several weeks ago and proposed that it simply be put in mothballs for at least a year. Thanks to the goodwill on many people's part, and particularly your own expertise in rewriting, I may have changed my mind. A *fine* article may yet come out of this.... Hayford Peirce 02:49, 2 December 2008 (UTC)


 * Gareth, I have only just begun to review your work, though my initial review is also quite positive. I am, however, concerned that the section "Contrasting views of homeopathy and conventional medicine" is placed even before "The basics of homeopathy."  It seems odd to provide a critique of homeopathy BEFORE describing what homeopathy is!  Dana Ullman 03:20, 2 December 2008 (UTC)


 * I agree - I've been more concerned not to lose text that I take out of sections and haven't given close thought to the order of sections.Gareth Leng 17:24, 2 December 2008 (UTC)

On Testing - I've moved this, agree fully with Chris that there needs to be a succinct summary here, that should also be the lead of the new article.

There is still a lot to be done, especially reorganisation! I have just started really, but will have to do my bit intermittently. Gareth Leng 17:49, 2 December 2008 (UTC)
 * I agree the organisation needs some work. The "Professional homeopaths: who are they?" section is currently a hodge podge of stuff that does not necessarily connect well. Chris Day 18:04, 2 December 2008 (UTC)
 * Several things in this section need to be written carefully. While there are homeopaths with full medical credentials, there are also CAM practitioners that have only classical homeopathic training. When physicians express concern about homeopaths, the concern is most likely about pure homeopathic approaches; it is not fair to imply that all homeopaths are medically qualified and only select homeopathic treatment after a considered balancing of approaches.


 * Again, there may be much valuable material available in the interpersonal dynamics. Howard C. Berkowitz 18:12, 2 December 2008 (UTC)

Safety and Vaccine Issues
Under the section on "Safety," there is this paragraph which I recommend that we delete, except for the 1st sentence (or that we rewrite entirely. The reference does not say that the chickenpox vaccine reduces incidence of herpes zoster (there seems to be a separate vaccine for that).

"Such advice is generally considered irresponsible by public health professionals. Adult herpes zoster infection is a reactivation of childhood chickenpox, which recurs along nerve paths, affects 1 in 3 adults, and can cause chronic, severe nerve pain of postherpetic neuralgia in 10-18% of cases, and eye involvement in 10-25% of cases. Chickenpox immunization prevents adult herpes zoster; a herpes zoster vaccine is now recommended for all adults 60 years and older. [69] Childhood immunization against chickenpox prevents herpes zoster. Measles is not a major killer in the western world, where the vast majority of children are vaccinated against the disease at about two years old. However, in less developed countries the death toll is much higher, and in 1999 there were 875,000 deaths from measles worldwide, mostly in Africa. In 2001, a "Measles Initiative" was initiated involving organisations such as the American Red Cross, UNICEF and the World Health Organization, and between 1999 and 2005 more than 360 million children across the world were vaccinated. By 2005 the death toll had dropped by 60% to 345,000. [70]" Dana Ullman 05:38, 3 December 2008 (UTC)


 * To clarify the specific, herpes zoster is a reactivation of childhood chickenpox, where the virus has entered cutaneous nerves and become dormant. If chickenpox is prevented, than the vulnerability for adult herpes zoster never develops. Both vaccines target the same virus, but in different manifestations &mdash; symptom complexes if you will. Now, Neustadter, a homeopath, wrote that the only benefit for chickenpox immunization is economic, variously keeping parents from losing time from work, and generating revenue for vaccine makers.


 * Neustadter, although well published in non-scientific circles as a critic of vaccines, does not, in any of his material I have read, seems to understadnd the relationship between herpes zoster (chickenpox) and herpes zoster (shingles). His biography shows training in oriental medicine and homeopathy, but nothing from a biomedical perspective. I didn't bring in his work in the first place; homeopaths did. His work, stands as a very good example of the sort of thing that frightens medical scientists and physicians about alternative practitioners that do not have the knowledge to understand the potential implications of what they claim. Now, if Neustadter had denied the relationship between these different viral diseases, it would be one thing, but it is, to me, telling that a prominent homeopathic author doesn't even seem to know it exists.


 * Dana, are you saying the materials about more generic anti-vaccine claims also be dropped? It was my understanding that Neustadter objected to it because "in part because some childhood infectious diseases may actually strengthen immune response, thereby reducing the incidence of certain chronic ailments such as asthma." Now, if he were to say "strengthen vital force", I'd say that is homeopathic art and I'd accept it as valid within the homeopathic system. As soon as the words "immune system", however, are mentioned, that seems far to ask about precisely what measurable immune factors are improved by childhood diseases. Generically, for example, are some protective of T4 lymphocytes?  To deal with asthma specifically, I'd certainly hesitate to say a "strengthened" immune response reduces asthma, because the mechanism of asthma is hyperreactivity in immune system cells called basophils and mast cells, or their hypersensitization by immunoglobulin-generating lymphocytes. Conventional treatment deliberately weakens these hypersensitive immune components, blocking the release of histamine and other inflammatory factors that cause, among other things the bronchospasm of asthma.  How does not giving childhood vaccines reduce inappropriate immunoglobin production or basophil/mast cell degranulation? If I made comments about similliums, a homeopath would have every justification to demand I explain my apparently superficial reason. Turnabout seems perfectly neutral fair play, presenting a claim in the context of the other discipline.


 * So, after all this time the assorted vaccine-related things have been brought in as homeopathic arguments, and not removed, or even questions raised from concerned homeopaths, these words seem a perfect example of the sort of issue that concerns physicians about homeopaths objecting to treatments that may very well have long-term serious consequences. Further explanation might help, but removing the material now would appear covering up very public homeopathic statements that show a lack of understanding of the knowledge a trained conventional physician should have. Howard C. Berkowitz 07:43, 3 December 2008 (UTC)


 * Sorry, I can't get back to consider this before the weekend; for now I've done some trimming and tightening; whether its needed depends on phrasing elsewhere I think. Gareth Leng 08:51, 3 December 2008 (UTC)

Question: is there no homeopathic pollution problem?
I often wondered what happens to the medicinal water that is necessarily discarded during the preparation of a, say,  30C solution. I would guess that this water, having medicinal/healing properties, is not safe to simply flush  into a city sewer system. Isn't there a pollution problem here? Storing and saving the whole batch cannot solve the problem either, because, suppose we start preparation from 1 (one) microliter (10&minus;6 L) of tincture, then a 30C dilution, i.e., dilution by a factor 1060, gives 1054 L. The volume of the Earth is 1024 L, so we need 1030 times the volume of the Earth to store all the succussed water that has been in contact with the medicinal substance during preparation. Hence it seems to me that discarding large volumes of the intermediate solutions is the only way out.

I wonder, are by any chance the more concentrated intermediate solutions less powerful so that flushing them is safe? Or do the concentrated solutions lose their essential healing properties sooner than the "beyond Avogadro" solutions? Or is there some mechanism in the sewer that annihilates the healing property of concentrated solutions and makes them safe? I hope that the homeopathic industry investigated this and found a solution (no pun), I don't like my drinking water contaminated with medicinal water. --Paul Wormer 13:31, 3 December 2008 (UTC)


 * Paul, no one knows with certainty what good or bad that dispensed homeopathic water has, though the premise of homeopathy suggests that only those biological systems that will react to a specific homeopathic medicine will be those that have some similarity or resonance to it. Also, heat and extreme cold as well as various fragrant substances have been known to neutralize homeopathic medicines, so whatever effects may happen in nature are usually undone.  I file this subject under:  interesting to investigate (if possible) but probably no big deal.  Dana Ullman 06:32, 4 December 2008 (UTC)


 * I am not clear how long the below paragraph has been in this article as is, but it is full of spectulation and straw man thinking. A weak and incorrect description of the memory of water theory is provided. Also, whoever wrote this does not seem to understand that ALL homeopathic medicines are made with a double-distilled water. This pharmaceutical grade water creates a standard for water which responds to the unsubstantiated concerns about "pollution" in the water used in homeopathy.  Further, the ideas expressed below about the extreme views of the "memory of water" are quite slopply intellectually and have no basis as being a problem. The statement about memory from "contact" is not even accurate because homeopathic medicines are made by contact, dilution, and succussion (vigorous shaking). Because of all this, I have deleted this paragraph because it seems not worthy.


 * "Non-homeopaths question if homepathic theory is logically consistent, pointing out what appear to be inconsistency. The theory assumes that water is imprinted by the properties of molecules that it once came in contact with, even when the molecules are diluted away. If so, then where did the pure water used in this process come from? The water that homeopaths use was once in contact with other chemicals, including chemical wastes, radioactive metals, dinosaur urine, and various poisons. According to this interpretation of homeopathic theory, all water in the world should remember its contact with millions of chemical substances and not just the properties of the chemicals that the homeopath claims will be useful.[61] Homeopaths respond by asserting that homeopathic manufacturers use a double-distilled water which may clear the "memory" of past water history." Dana Ullman 07:03, 4 December 2008 (UTC)

Has anyone studied the half life of homeopathic medicines? How long can they stay on a stores shelf before they become inactive? Chris Day 13:36, 4 December 2008 (UTC)


 * Half-life determinations, normally part of FDA Good Manufacturing Practices, are explicitly waived for homeopathic medicines. Howard C. Berkowitz 13:39, 4 December 2008 (UTC)


 * So the homeopathic medicines don't become inactive? Or does FDA just classify them as inactive? As for the latter, is that why the FDA does not regulate homeopathic medicine or is their stated reason that there are no serious side effects? Chris Day 13:47, 4 December 2008 (UTC)


 * Unfortunately, and without trying to be snarky, this is politics rather than science. The enabling legislation was enacted in 1938, when there was very little science of pharamacology. There was the Elixir Sulfanilamide disaster, which was the trigger. During debate, Sen. Royal Copeland, a homeopathic physician but apparently an objective man, did not want to see homeopathic medicines that had "passed the test of time" be subject to the the newfangled rules. As FDA and related regulatory organizations passed Good Manufacturing Processes, New Drug Application clinical trials, and the rest, homeopathy always managed to be grandfathered; I can't testify if that was a scientific determination of stability, a scientific determination that there was nothing to degrade, or a political maneuver.


 * In other words, Chris, there's never been a serious U.S., scientifically mediated discussion about the points you raise. It is clear that homeopathic drugs, for whatever reasons, are in a sanctuary from oversight except in egregious cases of misbranding. To some extent, the laws of other Western countries have some parallels. Is this valid material for the article? Should there be a stronger link to New Drug Application with compare-and-contrast?Howard C. Berkowitz 13:59, 4 December 2008 (UTC)


 * I'm not sure where it should be, possibly history, but these are things that have always intrigued me with regard to homeopathy. I think it would be good if CZ had this material somewhere. Chris Day 14:23, 4 December 2008 (UTC)

Howard, you didn't try too hard to avoid being snarky. If you are going to say or suggest something about "newfangled rules" (a very snarky reference), please quote and reference it. It would be more accurate to say that Copeland understood that the paradigm of homeopathy was different than that of allopathic pharmacology...therefore, grandfathering was perfectly appropriate. Please know that the manufacture of homeopathic medicines are strictly enforced. Manufacturers receive regular and unannounced visits, and the level of review is much more significant than the people here realize...and it is obvious that people here are not speaking/writing from real knowledge but just guesswork. Let's get beyond this... Dana Ullman 03:41, 5 December 2008 (UTC)
 * "the level of review is much more significant than the people here realize...". But it is not in this article, shouldn't it be? Especially if everyone is ignorant in this area. Chris Day 03:46, 5 December 2008 (UTC)

The Code of Federal Regulations is snarky?
I'm not going to argue whether Coleman's 1938 insight is appropriate for today. Further, there is little if any allopathic manufacturing today, since allopathy is an obsolete term in medicine, except when being used in a historic derogatory manner by homeopaths. Again, I'll remind you that Osler said that both allopathy and homeopathy needed to be succeeded by science-based medicine.

Want a quote? Nevertheless, the good manufacturing product is hardly guesswork; I suggest an apology is in order. Or did you want more of the actual language of the regulations?

21 Code of Federal Regulations: CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL PART 211 - CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS:
 * § 211.137 - Expiration dating.
 * (a) To assure that a drug product meets applicable standards of identity, strength, quality, and purity at the time of use, it shall bear an expiration date determined by appropriate stability testing described in 211.166.
 * (b) Expiration dates shall be related to any storage conditions stated on the labeling, as determined by stability studies described in 211.166.
 * (c) If the drug product is to be reconstituted at the time of dispensing, its labeling shall bear expiration information for both the reconstituted and unreconstituted drug products.
 * (d) Expiration dates shall appear on labeling in accordance with the requirements of 201.17 of this chapter.
 * (e) Homeopathic drug products shall be exempt from the requirements of this section.

If part (e) is not clear, homeopathic products are exempt from stability studies and expiration dating. Howard C. Berkowitz 03:53, 5 December 2008 (UTC)

Apropos of double-distilled water
From direct laboratory experience, double-distilled water isn't a panacea. When we prepared it for physical chemistry of protein, the bottles always had to be under soda lime locks to prevent carbon dioxide uptake, or had to be hermetically sealed with the reaction under inert gas.

Double distillation, without additional measures, does not prevent other gases from entering the water. IIRC, the first clanthrates involved xenon, and double distillation would be unlikely to exclude it.

Until the early 1940s, intravenous fluids were not safe even if prepared from double-distilled water. It turned out that pyrogens leached even from good-grade laboratory grade glass containers, and, until this was discovered and special containers (as well as tubing) developed, IVs could cause fevers of unknown origin. It is not an accident that most IV units are of a plastic very carefully designed not to leach impurities. Howard C. Berkowitz 14:06, 4 December 2008 (UTC)

5-45
In "with 5-45 minute follow-up consultations" does this mean there are typically five consultations that are 45 minutes long, or that there is an indeterminate number of follow-up consultations that range from 5 to 45 minutes long? --Larry Sanger 18:13, 3 December 2008 (UTC)


 * It was meant as 5 to 45 minute follow-up consultations (some consults are very short and others take more time). Dana Ullman 06:25, 4 December 2008 (UTC)

Paracelsus and alternative medicine
First, there is a History of Homeopathy page. Some participants here object to moving any history there, while others, including myself, feel the lead is too long and too argumentative and should shift. Howard C. Berkowitz 14:42, 4 December


 * There is a big difference between a look at the history of homeopathy and the theory of homeopathy. This new page serves a quite different purpose. Martin Cohen 17:42, 4 December


 * Given that there has been an intense discussion at Homeopathy, going back six archives' worth, involving the Editor-In-Chief, a current rewrite by an Editor, and extensive arguments, were I to see such a situation, I would hesitate before going ahead and creaing new pages, new models, and changing the text without presenting them on the talk page. Howard C. Berkowitz 17:57, 4 December

Second, I'm not clear whether you are proposing an alternative medicine page rather than complementary and alternative medicine. The latter is a generally preferred term, and there are very strong reasons not to separate the two. Synergy of disciplines, a potential benefit, is not going to come from separation. Howard C. Berkowitz 14:42, 4 December


 * I was 'suggesting' that the page title 'Alternative medecine' worked perfectly well, and that the inclusion of complementary medecine in the text itself was not thereby excluded. The longer title seems clumsy, makes linking more long-winded, and as I say, has left some links 'stranded'. Surely, as a general rule, we should respect page authors' choices of names for their pages except where there is a pressing need to do otherwise. Now I'm not saying you are wrong in this case, but I asked for the 'thinking' behind it. Martin Cohen 17:42, 4 December


 * Stranded links can be fixed. At least Matt and I on the talk page, and others in email, have specifically discussed the reason for the page name change. Complementary and alternative medicine have a well-understood meaning. Surely, as a general rule, I have little respect for page name choices by people that come into the midst of an extensive discussion, create new pages and paradigms without discussion, and do without asking. Again, the goal here is collaboration, not WP bold edit and revert, especially in tense situations. Howard C. Berkowitz 17:57, 4 December

Up to this point, the homeopaths have emphasized Hippocrates and Hahnemann. Bringing in Paracelsus, especially in the lead, is a rather radical change that should be discussed first. Howard C. Berkowitz 14:42, 4 December 2008 (UTC)


 * No founder is indicated in the lead to the article, an ommission that needed to be corrected. Hippocrates has nothing to do with the debate, other than having 'observed' that "By similar things a disease is produced and through the application of the like is cured” and Paracelus rather predates the Internet favorite Hahnemann. Many of Paracelus's actual remedies were based on the belief and approach that "like cures like" and in this he was practising what is today regarded as homeopathy. The article, correctly if ambiguously (because it might have led some to think that he also developed the principles) states that Hahnemann "described the principles". It seems a contradiction to me to say that he is the founder of the approach, and offer Classical references to its practise. At most, he could be the 'father of modern homeopathy', as some have put it. Martin Cohen 17:42, 4 December


 * You are making some flat statements that are not consistent with months of discussion. You haven't even presented your thinking on the Talk Page. Again, this is not WP, and, in an article with extensive rewrites and edit wars, bold changes and reverts do not fit the culture. Howard C. Berkowitz 17:57, 4 December


 * The aim of my addition is to broaden the discussion and include more contributors, including new perpectives. Alternative medecine, like homeopathy, should be described from an historical, a literary, a cultural, a sociological and most of all 'an alternative' point of view as well as the 'scientific' one. We don't need to, and should not seek to, impose blocks on the natural spread of information on CZ seeking to do this, as long as the new pages are suitably 'neutral' and follow normal standards of academic discourse. Martin Cohen 17:42, 4 December 2008 (UTC)


 * I suggest you ask Gareth Lang or Larry Sanger if "broadening the discussion" seems constructive for the dispute resolution that's been going on or months. Whether or not the material is or is not neutral, I find that you have unilaterally redefined the grounds for coverage or discourse, made no effort to seek consensus, and imposed your views on how the process should proceed. When I join an electronic forum, I tend to observe first until I understand the social dynamics. Howard C. Berkowitz 17:57, 4 December 2008 (UTC)


 * My name is invoked, and so I appear on the spot, Voldemort-like. Two things here--first, I would instead ask Martin to clarify his proposal, because I at least didn't find it entirely clear what he was asking for (what, for example would it mean to describe homeopathy as a "literary" "point of view"--which is literally what Martin said?), and also to explain a little more why he wants the change to be made.  Second, it is a little wrong-headed to suggest that such issues are always to be decided by some "higher authority" rather than dialogue and that avoiding controversy is a higher priority than taking on board new suggestions--surely we should not simply cut off debate simply on grounds that someone is new to the discussion. --Larry Sanger 19:40, 4 December 2008 (UTC)


 * Voldemort, old boy, thanks for the promptness. Larry, if I may use the informal, I have spent a good forty years working on electronic discussion groups. One of the basic rules of the Internet Engineering Task Force, which has managed to get quite a bit done, is that lurking to get the sense of a discussion is usually very wise. Otherwise, as we have seen at The Other Place, an active discussion can be disrupted because a newcomer arrives and wants explanation, or has proposals that might have been discussed three archives ago. Yes, you describe an ideal, but it isn't always practical if there is a goal of getting an article to some level of completeness. Even if this reaches Approval, there is always the opportunity for Draft Version 2. No, I don't regard that as wrong-headed but realistic. Howard C. Berkowitz 19:51, 4 December 2008 (UTC)


 * Yes, well, in my 15 years in and creating online communities, I have also frequently observed a self-appointed "old guard" arise and shoo away newcomers, which is probably a more serious problem on wikis. Anyway, my point, Howard, stands: let the man talk.  He isn't raising any issue that hasn't already been raised, as far as I know.  The first step, I think, is to ask him to clarify himself.  You might find that, after you get more clarification, you have nothing to object to. --Larry Sanger 20:09, 4 December 2008 (UTC)


 * Let us agree to disagree in part. Where I do see a repeating issue, however, is where WP assumptions are taken here. Bold-revert is not especially the custom, and we seem increasingly to be trying to make our pages link better; suddenly creating new pages about alternate paradigms are not conducive to navigation.


 * Nothing I have seen at CZ suggests that bold rewriting or creating of new pages, without talk page discussion of the issue, is a good direction. In fact, I had asked for clarification on some of these new pages; perhaps part of the problem is that what the man is saying is in no single place.Howard C. Berkowitz 20:23, 4 December 2008 (UTC)


 * If we agree to disagree, Howard, you are thereby overruled. My point was ultimately very simple.  You were wrong to imply that Martin may not speak his piece.  Yes, he may.  End of discussion on that point.


 * Also, the idea that we are now forbidding the editing of articles or creating new articles without prior discussion, which is exactly what you said, Howard, is just absolutely wrong. When we introduce that rule, CZ will have come to an end.  This is far too much ado about nothing (or little anyway).  As far as I can tell, Martin introduced some text that people disagreed with.  The proper response is to discuss the offending text.  Over and out.  No response is necessary, Howard. --Larry Sanger 02:14, 5 December 2008 (UTC)


 * Whatever the merits of the above arguments, it looks to me as if Martin has royally screwed up the formatting here, along with duplicating some of the text. I wish you'd learn to do things properly here, Martin -- it doesn't take much effort to reply (and indent, among other things) correctly. Hayford Peirce 18:09, 4 December 2008 (UTC)


 * Actually the problem was this edit from Howard. I think it was an edit clash with my previous one that resulted in duplicating much of the text. Chris Day 19:18, 4 December 2008 (UTC)


 * Ah, in that case, I must humbly apologize, Martin. Sorry -- it really looked as if you had done it.... Hayford Peirce 19:24, 4 December 2008 (UTC)


 * In partial defense of Martin, I may have induced some formating errors. When I first saw his remarks and replied, I had an edit conflict but was running late to an appointment. My very quick cut and paste to re-merge the comments may have caused some formatting or duplication problems.


 * That being said, looking at unusual formatting at, say the alternative Medicine (theories) page, I would have to agree that Martin might want to look at some of the customs and conventions. For example, Alternative Medicine (theories) has a nonstandard bold heading. It only links to homeopathy, lacking, in particular, a link to the existing complementary and alternative medicine. While I'm not compulsive of filling out entire clusters, complementary and alternative medicine at least has a fairly extensive, if redlink-filled, Related Articles page.


 * It would have been one thing to have questioned the links between homeopathy and complementary and alternative medicine, and discussed, in the talk page of the latter, why changes are needed. With the existing links, however, Alternative Medicine (theories) only seems to be there as an adjunct to homeopathy. In other words, there's no plausibly expected page where the issues are discussed; they are not specific to homeopathy so don't belong on those very full talk pages. Martin says he wants to broaden a discussion, but, in fact, there are ongoing, stressful, and active discussion with complex social dynamics. I'd be cautious before unilaterally saying they need to be broadened. Howard C. Berkowitz 19:20, 4 December 2008 (UTC)

I chose to delete Martin's addition on Paracelsus because it is simply incorrect. Hahnemann was a highly academic writer/author, and yet, he never ever referenced any of Paracelsus writings. Paracelsus may have written about the "doctrine of signatures," but many other healers over time wrote about the principle of similars, and yet, no one suggests that they are the "father" of homeopathy. Hahnemann coined the word, but more important, Hahnemann introduced "provings" (experiments in toxicology) to this system, thereby creating an experimental method to verify what a substance causes...and what it cures. Paracelsus' "signatures" concept is completely theoretical, suggesting that what a substance looks like is what it is effective in treating. This concept is simply vague. Hahnemann's significant background in chemistry and apothecary practice led him to various experiments that uncover "potentization" as the most effective way to increase a medicine's efficacy while decreasing its toxicity.

I appreciate Martin's boldness, though I encourage him to bringing significant changes or changes to the lead to the Discussion page first. The challenge here is to be bold but humble...and discuss, discuss, discuss. A fine balance. Dana Ullman 03:51, 5 December 2008 (UTC)

Constable input
Martin has not violated any Citizendium policy that I can see. We have nothing that states that newcomers (to the conversation) have to behave any differently than those that have been here longer. Do respect other authors and editors when making changes by clarifying your thinking on the talk pages. While large deletions without explanation are unprofessional, additions are encouraged as far as I interpret. More importantly, let's treat each other as we would like to be treated. D. Matt Innis 00:34, 5 December 2008 (UTC)


 * I think that Martin's contribution was quite useful. I will reference to the Work of Peter Morell (historian of medicine, with training in homeopathy and conventional biology), "Hahnemann and Homoeopathy".

Book review: Novel ideas / findings in the book

"Hahnemann was reluctant to associate his new system of medicine with the name of Theophrastus or Paracelsus for fear of being misunderstood or being accused of plagiarism. (p. 15)"

"The truth is of course, that Hahnemann was a second Paracelsus, but he felt he had to hide this fact. (p.72)"
 * --Pierre-Alain Gouanvic 18:37, 7 December 2008 (UTC)

elan vital
Is homeopathy's "vital force" in any way similar to Bergson's élan vital -- "vital force" or, apparently, more correctly, "vital impetus"? Hayford Peirce 18:02, 4 December 2008 (UTC)

Neutrality Notes?
Would anyone like to take a crack at making Neutrality Notes for this article?

I'd like to see how someone else would do this...and whether anyone is motivated...and whether we'll be able to agree on the results...and whether they will help at all. Also, I'd need another example for the use of the Editorial Council. --Larry Sanger 19:31, 4 December 2008 (UTC)

Bioavailability, proving, safety
I'm not sure who wrote the text comparing provings to safety tests; while it has my edit note appended; I didn't write that and wouldn't have written it.

Nevertheless, I agree there is no equivalence to bioavailability when something cannot be tested. I don't really understand Dana's edit comment, which I wish had been put on the discussion page.

Dana's note:"Safety and efficacy of homeopathy: Provings are NOT like safety tests. They are experiments in toxicology to see what each substance CAUSES, even in potentized doses, in healthy people.)"

This confuses me. Toxicology, in general use, is the study of substances that interfere with normal processes. In medical terms, a toxicology experiment that does not assess safety simply doesn't make sense. Does "toxicology" have a specialized meaning in homeopathy?

Actually, this brings up a question: are there new homeopathic remedies for which provings are needed, or is the list of remedies closed? If there are new remedies, is it correct to assume there is no safety testing in the sense of pharmacology, and it may safely be assumed all homeopathic drugs are risk-free? That's not snark, but what seems to be an assertion I'd like to understand. Howard C. Berkowitz 21:10, 5 December 2008 (UTC)

Allopathy and asthma
First, I have deleted several references to "allopathy" when it appears to be used as a means of describing current medicine. I believe the ground rules established that this, even more than "skeptic", is considered a biased word and needlessly inflammatory. Further, the term is simply no longer used except in historical (e.g., 100 year old) discussions of philosophies of health, and, regretfully, in what seem to be attacks on conventional medicine by homeopaths. There are many other ways to describe non-homeopathic approaches to treatment which are more accurate than allopathy.

Second, flat statements that allopathy can't cure diseases need sourcing, not just a statement of opinion. "Cure", itself, needs statistical definition. It is fair to say that on the basic of large-scale, evidence-based studies, conventional medicine, with relatively recent therapies, can control asthma. Control means that there are few or no symptoms that distress the patient. "Cure" would mean the disease disappears for all time, with no need for further acute or maintenance treatment.

In this area, where evidence-based data is available, it does not seem reasonable to claim that small trials (10s of patients over short periods) flatly prove the advantage of homeopathy over large trials (thousands to tens of thousands) of conventional methods. Howard C. Berkowitz 13:32, 6 December 2008 (UTC)


 * With respect to "allopathy" does anyone claim to be able to cure asthma? Likewise, would anyone claim to cure cystic fibrosis? Having said this, I'm not sure of the context in which this comes up.
 * Does this mean homeopaths do not distinguish between infectious disease and genetic disease?
 * How does the comment "allopathy can't cure diseases" relate to homeopathy? Is it to say that homeopathy is as good as conventional drugs or is there a claim that homeopathy can cure?
 * What is the best study available to show that acute asthma can be controlled by homeopathy. These claims of treating acute asthma are remarkable and either prove the efficacy of homeopathic treatment beyond doubt or are an exaggeration.
 * Howard, are you commenting on a specific paragraph here, one only dealing with asthma, or is this a more general comment? Chris Day 16:50, 6 December 2008 (UTC) edit: just found the relevant edits


 * Although I had no problem with deleting the word "allopathy" in the one instance of deletion that I just found, people here should know that the word "allopathy" is not just a historical word but is COMMONLY used today by many of the most prominent medical organizations. For an impressive list of sources, see:  http://en.wikipedia.org/wiki/Talk:Allopathic_medicine#Additional_references


 * Sadly, however, the editors at wikipedia have rewritten history and present status of this word, and their article on allopathy is typical of many health articles at this site (it is ridden with POV and strong bias).


 * That said, I agree with others here who express concern about the statement "allopathy can't cure diseases." Dana Ullman 18:50, 7 December 2008 (UTC)


 * First, Wikipedia is rarely considered an "impressive" source at CZ. Many of the references it cites, however, do not treat allopathy as an antonym of homeopathy, but of osteopathic medicine. Many of the references are historical clarifications from administrative bodies.


 * Second, I believe the ground rules have established that allopathy is not considered a current term for describing mainstream medicine. Specifically,
 * "'Allopaths' won't do, either, although it certainly can be introduced, and it should be."
 * I agree it is commonly used by critics of mainstream medicine, but William Osler described, in a quote I have frequently provided, that he considered both homeopathy and allopathy to be obsolete. By all means define it, but in proper historical context, explicitly including the Osler quote to which I refer. Howard C. Berkowitz 19:03, 7 December 2008 (UTC)

Did anyone browse through that talk page at wikipedia? It is painful. Why is there such a need by proponents of CAM to use the term allopathic? The amount of time and effort popularise a term that is hardly used, or worse, incorrectly used by people that should know better, is mind boggling.

Interesting commentary here: 	Katherine E. Gundling When Did I Become an "Allopath"? Arch Intern Med. 1998;158:2185-2186.

Or have we already moved into an era that this term has been reinvented and now has a different meaning to Oslers time? Certainly terms such as epigenetic and gene have evolved in that time. If the usage has changed we need to be very clear that allopathy from 200 years ago is not synonymous with this current usage by some. Just out of interest, what is the exact definition as proposed by Hannemahn. Chris Day 19:25, 7 December 2008 (UTC)


 * I too have serious concerns about wikipedia, but I was referring to ONE specific reference at wikipedia that provides a detailed body of evidence of the modern (!) use of the term "allopathic". I was actually surprised myself how many leading medical organization self-define themselves using the term allopathic.  See for yourself by going to the link that I provided.  That said, K.E. Gundling's piece is just one voice...the reference above provides much more substantative evidence.  Dana Ullman 01:46, 8 December 2008 (UTC)


 * The more I think about this the more I think this is effectively an evolving term. This would explain why some physicians object strongly to the usage of the term while others embrace it; it all depends on their own working definition. As I mentioned above, this happens with science terms too and frequently leads to pedantic arguments . Hopefully we can navigate this without going wikipedia. One good starting point is to acknowledge that the term is  possibly confusing and not assume that the usage of allopath is similar between eras or even similar between all people now. Chris Day 02:38, 8 December 2008 (UTC)

Unilateral revision of edit because "it is not acceptable to homeopaths"
To avoid edit and revert wars, especially when there have been multiple intervening edit, I refer to Ramanand's changes of Revision as of 06:00, 6 December 2008 with the edit comment "→this is what there was earlier-the new edit isn't acceptable to the homeopaths"

If the language is that unacceptable to homeopaths, than mutually agreeable language has to be worked out on the talk page. Otherwise, we have a revert war. I object to the language to which the material was reverted.

Is this a constable matter of avoiding a revert war? Howard C. Berkowitz 13:36, 6 December 2008 (UTC)


 * I agree that a reversion of a section that had previously cleared two editors should not be reverted by an author. I have reverted to the last version that was reviewed by an editor and brought both versions to the talk page where you can discuss issues. D. Matt Innis 16:52, 6 December 2008 (UTC)


 * Conventional physicians take a medical history according to medical principles, classical homeopaths will take a history only using homeopathic priciples, and homeopaths with both medical and homeopathic training will then take additional history according to homeopathic principles, Classical homeopaths do not use medical physical examination, diagnostic imaging and tests from the clinical pathology laboratories as suggested by the differential diagnosis, and questions raised by the history and physical examination. Homeopaths that are licensed to perform these additional studies do not practice classic homeopathy, but rather a an alternative or "mixed" form.
 * Classical homeopaths place more emphasis on the way a person experiences their disease than on diagnosing the disease - i.e. they give priority to the syndrome of symptoms rather than to the results of conventional medical tests. This differs strongly from the conventional medical approach to finding the etiology of the disease proper, not its syndrome of symptoms.


 * This is completely wrong-the diagnosis is important, for example the list of remedies used for bronchitis can't be used for cholera. That is why I replaced it with the earlier version.&mdash;Ramanand Jhingade 08:15, 8 December 2008 (UTC)


 * It would seem, then, that part of the problem that non-homeopaths have with accepting these assertions is that it is not clear to them how homeopaths diagnose, and, once they have diagnosed, if there is any more to selecting remedies than looking up a set of symptoms in a repertory. This, again, comes back to what I've been calling the "cognitive process", which, in medicine, is the thought process that includes both diagnosis and selection of treatment. In contrast, the "procedural" process in medicine is performing a treatment, or perhaps an invasive diagnostic procedure, such as surgery.


 * At the core of the commuications problems here, I suggest, is that homeopaths have internalized certain approaches to interacting with patients, and it is so internal that there is difficulty in accepting that anyone who has not gone through homeopathic training does not think the same way. In like manner, however, people writing reasonable articles about conventional medicine understand that the average reader has not had professional training, so they explain the thinking, either in the article, or in a series of linked articles that go back to basics.


 * The homeopathic approaches might get more attention if the homeopathic authors concentrating on explaining what they do, including, if I quote Gareth correctly, the things that homeopathy is claimed to help. Continuing arguments about history, early studies about potential modes of action, etc., take the article away from that absolute core information. Simple assertions of "it doesn't work that way" are not enough to be convincing to someone trained in a different paradigm, for which the training is based on a fairly formal structure.


 * Constable/Editor: since I believe this is one edit back, I don't want to revert. I do believe, however, that this discussion needs to be worked out on the talk page, not with inline edits in the article. Howard C. Berkowitz 16:45, 8 December 2008 (UTC)


 * Constable response: Thank you for not reverting. Improvements are always allowed so long as large amounts of material are not deleted without discussion or editors have asked that the text not be altered.  At this point, I believe the paragraphs in question have pretty much been struck by an editor.  It's up to the editors to decide what stays in. As Gareth has acted on this one, any improvements would obviously have to make it through him as well as Dana. D. Matt Innis 18:25, 8 December 2008 (UTC)


 * Qualified medical and other Health professionals who practice homeopathy perform medical history taking, which is supplemented with homeopathic history taking. They also perform a basic physical examination, with additional examination of body parts or systems that may be associated with a symptom; diagnostic imaging and tests from the clinical pathology laboratories as suggested by the differential diagnosis, questions raised by the history, and physical examination. Investigations like blood and urine analysis and diagnostic imaging, can be helpful but are generally not essential for selecting a homeopathic remedy.
 * To determine which remedy to prescribe, classical homeopaths place more emphasis on the way a person experiences whatever disease they have more than the name of the disease s/he has. They thus give higher priority to the unique syndrome of symptoms of the patient than the objective results of conventional medical tests.


 * These 2 paragraphs are more accurate.&mdash;Ramanand Jhingade 08:15, 8 December 2008 (UTC)


 * In all due respect, I don't see the difference. Please elaborate on when the "diagnosis is important", as much of the homeopathic writing seems to emphasize that the medical model of a diagnosis, which is a direct consequence of a pathological etiology, is irrelevant; it is symptoms that are important. It may be that homoeopaths use the word diagnosis differently than do physician, diagnosis is principally derived from a determination of etiology, in combination with models of physiology and pathology. Etiology, in turn, considers history, physical, and laboratory tests  Right now, I'm completely confused on what homeopaths mean by diagnosis, as it seems they make a diagnosis without determining an etiology, depending instead on syndromes of symptoms. If this is not the case, please clarify.


 * To a conventionally trained practitioner, the results of the tests, combined with the history and physical, form the basis for diagnosis. Treatment/remedy selection is a next step, as is the prognosis.Howard C. Berkowitz 18:29, 8 December 2008 (UTC) (left out date/time in earlier comment and don't know how to get it back. Sorry> It is in response to Ramanand Jhingade's comment of 08:15, 8 December)


 * The 'method' of diagnosis is the same, it is only the 'method' of remedy selection that differs.&mdash;Ramanand Jhingade 06:27, 9 December 2008 (UTC)

Pharmacopœia (or whatever the plural may be)
There may be a usage difference between homeopathy and conventional medicine. The general, non-homeopathic United States Pharmacopœia, as well as the related but subtly different National Formulary, is not that uncommon to find on the reference shelves of physicians especially interested in pharmacology, along with a standard textbook such as Goodman & Gilman's The Pharmacological Basis of Therapeutics, along with more specialized works.

There is an organization called the United States Pharmacopœia that produces several books, the USP and NF being the core ("basic" in the sense they are fundamental references), but also a practitioner guide called USPDI. I'll have to look up the "DI", which I think stands for Drug Indications, and is a specifically practitioner oriented book, or, as I use it, a database. It's better written than the Physician's Drug Reference, which is a compendium of the exact text of FDA-approved package inserts, basically written by lawyers.

One of the reasons that conventional physicians may keep the USP is that it can be the best place to find "inert" ingredients that really are not. For example, many tablets are colored with tartrazine, also known as "Yellow No. 5". This dye can trigger asthma in susceptible patients. The USP may indicate if an approved tablet can contain tartrazine, which may be very important to know.

My point is not to be so abrupt at assuming that a reference has only one purpose, or, at least, to indicate it has only one purpose in homeopathy. My assumption that a Pharmacopœia is of clinical interest is based on experience, not guesswork. Unfortunately, I find a certain tendency, in this article, to assume that the homeopathic usage of a term is the only possible interpretation, which leads to ambiguity. As, I believe, Chris said, it cannot be assumed that the reader of the article is a trained homeopath, so if words are used in a specialized way, they need to be disambiguated. It is not helpful to put down people that have experience with a term in mainstream medicine and have no reason to know homeopaths use the word differently. The article needs to educate on such matters, not huffily suggest going to read a homeopathy textbook. Howard C. Berkowitz 20:52, 6 December 2008 (UTC)


 * Second, I know how the Food and Drug Administration in the U.S., as well as equivalent regulatory bodies in other countries, use pharmacopeias. I repeat: a pharmacopeia is a basic document, at least to a manufacturer, "basic" in the sense that it is a foundation of good practice. The United States Pharmacopeia, for example, is a basic reference for drug manufacturing in the United States, although it has clinical applications besides manufacturing. The Handbook of Chemistry and Physics is a basic document, but "basic" does not equate to "elementary".


 * As an "author, publisher, and seller" of homeopathic books, perhaps one might wonder if you should be making flat statements about things where you may have a financial interest? I am indeed a book author, but don't sell them directly; when I do write for profit, I clearly identify any possible relationships in other writings. I recommend this practice.


 * So, yes, I do know that those familiar with Good Manufacturing Practice (a legally defined term of art) of drugs, non-homeopathic and homeopathic, generally accept certain things to be true. You denied that the FDA exempted homeopathic drugs from certain aspects of Good Manufacturing Practice. I responded not only with the citation from the U.S. Code of Federal Regulations, but with the actual text of the exception. After your initial complaint, you have made no comment on the requested documentation that I provided. Do you still maintain that the FDA does not exempt homeopathic drugs from parts of the Good Manufacturing Practices that apply to every mainstream product it regulates? Howard C. Berkowitz 18:52, 7 December 2008 (UTC)


 * Howard, I never denied that the Homeopathic Pharmacopeia isn't a standard reference for homeopathic drug manufacturers, and in fact, this is exactly what I have asserted. I cannot help but sense that you've never seen or read the homeopathic pharmacopeia because, if you had, you would know that there is NO clinical information about any medicine in it.  This text is ONLY of interest to drug manufacturers, not to clinicians or consumers, and THAT is why I didn't want to confuse readers here by saying that the Homeopathic Pharmacopeia was the "third standard reference" book in homeopathy. It is not such. These facts have NOTHING to do with any financial interest on my part...they are simply statements of fact.  I am confused how or why you would suggest that such facts somehow are tainted in any way.

Dana Ullman 01:59, 8 December 2008 (UTC)

Individualization and permutation
Gareth, I certainly agree there are limits to polypharmacy in mainstream medicine. In some of my work with expert systems in prescribing, one of our first tasks is often to figure out just what the patient is taking, often from multiple prescribers that do not talk to one another. One of my research areas is analyzing multidrug regimens to see if they can be simplified, to increase compliance, avoid side effects, and, when possible, optimize combinations that address comorbidities.

Nevertheless, the point has been hammered that homeopaths "individualize" to a greater extent than do mainstream physicians, and this is a refutation that medicine is a rigid structure that does not consider individual patient needs. That's all I'm trying to accomplish. If the homeopaths stop making the distinction that physicians do not individualize for specific patients, I'm happy to drop the whole issue, but as long as that insistence is made, I see it as non-neutral and inaccurate.

Treatment of a patient with clinical AIDS, for example, is highly individualized, starting with the selection among many highly active antiretroviral therapy (HAART) regimens, then adding prophylaxis as indicated by the degree of immunosuppression and specific risk factors, then treating associated clinical disorders such as AIDS wasting syndrome.

Can we come to some agreement that both disciplines individualize according to their own model, and not continue to have a superiority clash that one side is the only one that understands individualized treatment? I'm talking about widely used treatment, incidentally, and not yet touching genetic medicine. Howard C. Berkowitz 22:24, 7 December 2008 (UTC)


 * This "more personalalized/individualized" experience claim reads too much like an ad. Since there are homeopathy practitioners contributing here, the article could easily have some pictures. (Chunbum Park 22:43, 7 December 2008 (UTC))


 * Hi Howard, yes this is an issue that needs to be handled - at present the "Conflict" sections are like minutes of unresolved editorial disagreement rather than helping the reader and we need to fix these - but that requires a bit more time and thought than I'm able to give immediately. I'm afraid I'm going for what seem to be the most obvious fixes first - what I've left I've left not because I think its OK but because it needs more care. However, yes I agree that the article should not seem to imply that conventional medicine does not seek individualized treatment - that would be inconsistent with at least a large trend in modern medicine to identify individual genetic risk factors.Gareth Leng 22:46, 7 December 2008 (UTC)


 * There are some clear omissions from this article. Most obviously to me, there needs to be a section stating clearly exactly what claims are made for homeopathic remedies. This needs to be phrased in such a way that it is clear that the claims are being reported not asserted, but this section is very important. This will not be the place to discuss the validity of the claims - that's the job of the testing article - so this shouldnt be controversial if phrased properly. It seems to me essential to understand exactly what homeopaths say homeopathy can be used for.


 * I'd also like to see a very specific example of a particular proving.Gareth Leng 22:55, 7 December 2008 (UTC)


 * Thanks; you are going in a good direction. I like your " It seems to me essential to understand exactly what homeopaths say homeopathy can be used for." To me, this is what I have been asking and asking about what I've termed the "cognitive process" of a homeopath-patient encounter, and still have not gotten an answer.


 * In some cases, the answer has been that the practitioner uses all their training, homeopathic or not, to decide what is appropriate. To me, that's a non-answer, although it's usually coupled with a comment that everything is individualized and I'm not accepting the homeopathic paradigm, but expecting an etiological one. Even if that is literally true, then the homeopathic paradigm needs to be explained in enough detail for a non-homeopath to have an idea what is done. Saying that the syndrome is looked up in a repertory until something matches and a remedy is prescribed, again, feels like a non-answer. If there are cases where a homeopathically qualified physician selects medical treatment, or complementary medical and homeopathic treatments, I really can't accept that no concrete examples can be given. Isn't that what would be taught in homeopathy school?


 * Apropos of provings, I have not seen anything mentioned that indicates active work in proving new remedies. Perhaps the reference books (not trying to distinguish among repertory, materia medica, or pharmacopeia) are, indeed, considered to be closed systems needing no additions. If so, I'd like that to be stated explicitly. If homeopaths do research new remedies, I'd like to know what aspects of treatment they are trying to improve &mdash; that's not in the least meant to be sarcastic or snarky. Howard C. Berkowitz 00:21, 8 December 2008 (UTC)

Vaccination
Ramanand Jhingade just wrote "this certification is a must" when adding the bolded text to complete the following:
 * "Homeopathy is based on "the principle of similars", which asserts that substances known to cause particular symptoms can also, in low and specially prepared doses help to cure diseases that cause similar symptoms. This principle is not accepted by mainstream medicine or by conventional scientists today, although the principle is used in vaccination."

Do all vaccinations cause symptoms? I realise that some do, if using attenuated viruses but i don't think most vaccinations cause symptoms. I think this addition is only valid if the recreation of symptoms is a key to the success of vaccination but i don't think this is the case at all. Any doctors want to comment here? Chris Day 07:10, 9 December 2008 (UTC)

Couple of edits

 * Homeopathy is not considered an Indian system of medicine in India.
 * there are references for the fact that homeopathy can treat acute bronchitis effectively
 * &mdash;Ramanand Jhingade 07:25, 9 December 2008 (UTC)