Talk:Homeopathy/Archive 15: Difference between revisions

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


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


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


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


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


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


::::The proposed new definition also overemphasizes the aspect of small doses and does not address the apparent rejection, by homeopathy, of the idea of "disease". Instead, it speaks of "restoring health", without addressing the  meaning of the state of non-health.
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:::Please confirm or correct the statement that homeopaths do not believe in the concept of disease, in the sense that disease has an etiologic cause and the cause needs to be corrected. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 08:30, 19 September 2010 (UTC)
In the section "A typical homeopathic visit":
: (which they feel may be ineffective and/or likely to have side effects).
should probably read
: (which they feel may be ineffective and/or '''not''' likely to have side effects).  
--[[User:Peter Schmitt|Peter Schmitt]] 01:27, 9 December 2010 (UTC)


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


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


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


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


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


The current draft has:


----
{{quotation|Homeopathy is used mainly by consumers who use it to treat common non-life-threatening acute conditions, by a relatively small number of licensed homeopaths, and by some medical doctors and other licensed health practitioners as an alternative or a complement to conventional treatment. Homeopathic medicines (referred to in this article as "remedies" to avoid confusion with conventional medicines) are widely available without a doctor's prescription. Some health insurers cover homeopathic treatment if it is provided by a medical doctor or a naturopathic physician.}}
The above comments have been copied from the [[Talk:Homeopathy/Archive 13|Archive]]. --[[User:Peter Schmitt|Peter Schmitt]] 10:28, 20 September 2010 (UTC)
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===Natural defenses===
There is an implicit homeopathic assumption here here that natural defenses are always sufficient, that restoring natural defenses equates to health. From a medical standpoint, that is sufficiently wrong that "natural defenses", or the idea that full health is a matter of restoring defenses, is rather basic. Consider, for example, genetic diseases such as [[cystic fibrosis]] or [[hemophilia]]. The problem, from a medical standpoint, is that the "natural" state is incomplete for health. With genes missing to produce the proteins that produce health in a "normal" person, all the "strengthening" in the world will not strengthen something that isn't there. In [[severe combined immune deficiency disorder]], the most pronmising research to externally insert the gene that encodes the manufacture of the key missing enzyme, adenosine deaminase.
 
In other words, sometimes the wisdom of the body is pretty damn stupid, and all the strengthening in the world can't replace something that isn't there. It doesn't help explain etiology when etiology can be due to an absent rather than a present cause -- but how else do you talk about sensibly about deficiency and genetic diseases?  The evidence that [[scurvy]] comes from inadequate vitamin C is overwhelming.
 
Proposal:
 
"Homeopathy is a form of [[alternative medicine]] that holds that good health is achieved purely by strengthening what homeopaths, but not conventional medicine, calls "wisdom of the body" or "natural defenses". Homeopaths further believe that all problems of natural defenses manifest themselves as symptom complexes, and reject the idea that disease has a cause and health is restored by the removal of the cause. They hold that the symptoms show the defenses that need to be strengthened, and their remedies are based on a symptom, not cause, oriented paradigm. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 11:05, 20 September 2010 (UTC)
 
: The definition is supposed to ''briefly'' say what homeopathy ''is''. It needs to be short enough to fit into a related articles page. To me, your suggestion fails at those goals; either the current text or my suggestion above seems far better.
: There needs to be discussion of these issues somewhere in the article, perhaps even in the lede, but it does not belong in the definition. [[User:Sandy Harris|Sandy Harris]] 12:17, 20 September 2010 (UTC)
 
::I'm fine with both of Sandy's definitions. I hope one of you can make time to correct the definition at the top of this page - it should be '''alternative''' and not '''alternate'''.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:21, 20 September 2010 (UTC)
 
:::Absolute minimum: Homeopathy is a form of [[alternative medicine]] that holds that good health is achieved purely by strengthening what homeopaths, but not conventional medicine, calls "wisdom of the body" or "natural defenses", rejecting the medical model that the etiologic cause must be corrected.
 
:::The method by which remedies are selected (i.e., provings) and prepared are irrelevant to the core definition. According to Mr. Ullman, not every homeopathic remedy is given in "homeopathic doses", so let's not overemphasize the small dose issue. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:32, 20 September 2010 (UTC)
 
(unindent)<br>
I suggest something like:
: "A system of alternative medicine, developed around 1800 by Samuel Hahnemann, based on the assumption that self-healing can be stimulated by small doses of substances that cause the <s>same</s>similar symptoms as those to be treated."
--[[User:Peter Schmitt|Peter Schmitt]] 21:58, 20 September 2010 (UTC)
 
::I am very concerned about Howard's "implicit assumptions" about homeopathy because he is simply wrong about them.  Homeopaths do NOT believe that the body's natural defenses are always sufficient for restoring health. To be candid, this is a totally ridicious assumption, and after ALL of this time in which Howard has been editing this article, I am surprised that he would believe such a ridicious assumption.  I urge all editors to avoid guessing at what homeopaths think or do.  Please consider ASKING before assuming or at least making reference to a specific established expert who made a specific statement. Our encyclopedia here deserves better scholarship than something based on assumptions, let alone "implicit assumptions." When an editor here has some deep antagonism to homeopathy, it is particularly important to avoid making assumptions without specific and references FACTS because such assumptions tend to create "straw men" (a problem about which I have frequently expressed concern in the past).
 
::IF the natural defenses were always sufficient, there would not be any need for healing treatments.  That said, homeopaths do believe that our symptoms represent the best defensive efforts that the bodymind can deploy at that time based on its present internal resources.  However, such efforts are often not enough, and therefore, medicinal and/or therapeutic efforts are necessary.  Homeopaths believe that those efforts that mimic and augment these natural defenses will be the most effective, while methods that suppress, inhibit, or work by counteracting the body's symptoms may provide "benefit" briefly but will tend to create more serious physical and psychological symptoms and syndromes in the longer term (homeopaths refer to this phenonmenon as "suppression of disease," while conventional physicians simply refer to them as "side effects"). 
 
::Howard is also inaccurate about his understanding above about "homeopathic provings."  Howard wrote: "The method by which remedies are selected (i.e., provings)" -- To clarify, "provings" are experiments in toxicology that verify the specific symptoms and syndromes that each substance CAUSES in overdose.  After a homeopath interviews a patient, the homeopath looks to find a substance that has been found to cause in healthy people the similar syndrome of symptoms that the sick person is presently experiencing. 
 
::I urge Howard to prove and verify that a homeopath and an allopath would have different definitions of "the wisdom of the body."  I personally do not know of any such difference.  Yes, I do have a deep antipathy to homeopathy, but it's rather hard to come up with citations for negative information. Harrison's and Cecil's, as a start, don't use the term.
 
::BTW, Peter's defintiion above is inaccurate.  Homeopaths do not use substances "that cause the SAME symptoms..." but instead "that cause SIMILAR symptoms."  Get it?  Homeopathy IS based on the principle of SIMILARS.  That said, there ARE some applications in homeopathy that "treat SAMES with SAMES" (as in the 4 studies by Reilly and his team at the University of Glasgow in their treatment of people with various allergic ailments, where they used potentized doses of specific ALLERGENS to which people were most reactive.  [[User:Dana Ullman|Dana Ullman]] 09:08, 21 September 2010 (UTC)
:::::: I changed the text accordingly. --[[User:Peter Schmitt|Peter Schmitt]] 23:12, 22 September 2010 (UTC)
 
:::Thank you, Dana, because you are now being more specific and more limiting about some things that either have been said previously by you, or by Ramanand.
 
:::I have never said that an allopath has any assumptions about the wisdom of the body, because I don't know any allopaths. If, by "allopath", conventional physician is meant, the proof is easy: "wisdom of the body" is simply not a medical concept. I don't see it in the index of any of my major textbooks of internal medicine. Ignoring the continued insistence on allopath, the difference on wisdom of the body is binary: one discipline believes in it and one does not. You asked an apparently rhetorical question about belief in wisdom of the body, which I answered that I, and most medical scientists, do not believe there is such a thing.
 
:::Whether or not there is a historic use of allopathy, in the United States, people are licensed as physicians (nurse practitioners, physician assistants, etc.), not allopaths. Homeopaths, where licensing applies are, as far as I know, licensed as homeopaths. I can ask him to see if there's a difference, but my best DO friend's licenses to practice in Missouri and Louisiana are for the practice of medicine, not allopathic or osteopathic medicine.
 
:::"However, such efforts are often not enough, and therefore, medicinal and/or therapeutic efforts are necessary. " Agreed, but please be specific. The existing alternate rather than complementary emphasis of the article has made quite a point of saying homeopathy comes first.  A short list of examples where a homeopath would call for an ambulance would be very informative.
 
:::Correction. Remedies are not selected by provings, but are they not the means to find a simillium?
 
:::It's now on the archive page, Dana, but I thought you said homeopathic remedies were not always given in homeopathic dosages. If I remember that correctly, then the "wisdom of the body" and strengthening defenses, perhaps with a few words about the difference with medicine, is more central to the definition than the aspect of small and specially prepared doses. Both belong early in the introduction. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 10:40, 21 September 2010 (UTC)
 
Howard, thanx for clarifying some issues.  You have suggested above that conventional physicians really do not have a specific meaning for or appreciation of "the wisdom of the body."  To me, that alone says volumes...and I agree with that.  In fact, it seems that the average physician has distrust of the ability of the human body to defend and repair itself, thereby requiring intervention that usually (though certainly not always) works counter to the body's present symptoms. 
 
As for the use of the word "allopathy" and "allopathic," you may be very surprised and even shocked how many conventional medical schools, licensing boards, institutions, US governmental agencies, and accrediting agencies still utilize this word. I highly recommend that you see the "huge body of references" compiled by Brian Hopping at:  http://en.wikipedia.org/wiki/Talk:Allopathic_medicine
 
To clarify on the licensing of homeopaths, there are only 3 states in the USA that license MDs who practice homeopathy (CT, AZ, and NV).  Licensing in homeopathy is NOT necessary to practice homeopathy.  FYI, these 3 states licensed MD/homeopaths because some MDs who practiced homeopathy were being harrassed by conventional MDs, so they set up their own licensing board.  Most MD/homeopaths are NOT being harrassed by other MDs, so it is not necessary to set-up their own boards. 
 
In addition to MDs who practice homeopathy, virtually every type of health/medical professions have some people who practice homeopathy, PLUS there are "professional homeopaths" (individuals who specialize in homeopathy and who are not licensed in any other health/medical profession).
 
As for when a homeopath would call an ambulance...it would be the same protocols for which conventional MDs would call an ambulance.  Is that clear enough?  [[User:Dana Ullman|Dana Ullman]] 17:11, 21 September 2010 (UTC)
 
:OK, please take the following on ...well, good "faith" is singularly inappropriate, for a reason I think you'll soon see. I'm not exactly suggesting there is a consensus, but I would hope that it might be possible for the different sides to have their incompatibilities, and indeed fears, clearly stated.
 
:I could get along with "wisdom of the body" in the context of religion or transpersonal psychology, but not medicine. By "medicine", I use Marcia Angell's definition: there are two kinds of medicine. Medicine that works and medicine that doesn't work. Yes, adults have a right to faith healing -- but courts have held they do not have a right to do so for children. It frightens me, quite literally, that a parent might take a child with diabetes, or a treatable cancer, to a homeopath.
 
:The rejection of etiology also frightens me, given the level of improved certainty that comes with genetic and molecular medicine. I see, in homeopathic writing, a pattern of encouraging fear of medical sciences. I see the emphasis on using the word "allopath" as trying to reopen old political and just plain angry battles.
 
:Now, remember that this discussion has been international, in the sense that Ramanand has been bringing up Indian practices. Perhaps Western homeopaths would never do such things, but he has given me the impression that ambulances -- and yes, they might not be available in some countries -- would not be called until late or never.
 
:That most homeopaths are not licensed or reviewed is not very confidence building.
 
:I can only say that in several decades of working with health care, I have ''never'' met a physician who used homeopathic methods. I'm not saying they don't exist -- I'm saying that at least in the U.S., homeopathy does not appear to be a significant form of complementary medicine. I do know quite a few physicians that either themselves use other alternative methods, or integrate care with alternative practitioners.
 
:[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 20:53, 21 September 2010 (UTC)
 
::OK, I may need to be more focused.  There's been too much talk page discussion that doesn't have anything to do with improving the article. I'm probably especially irritable about health care at the moment, as I'm dealing with the last comfort-care-versus-euthanasia decisions for my best friend--who, incidentally, may well have benefited from some complementary veterinary medicine.
 
::The "wisdom of the body" discussion is the only thing I'll raise right now.  While I don't see that historically as the core of homeopathy, certainly the article can say this is something in which many homeopaths believe, and define it in declarative sentences. Also in declarative sentences, it is fair to say that biologically oriented clinicians find it to have no information that will help a patient, and denies that which has been learned in over a century (well, maybe since somewhere mid-20th century) about etiology and efficacy. Neither side will convince the other, and both sides have equally intense beliefs.  Treat it as a religious difference based on faith, stop trying to argue the positions ''in the article'', and move on. Dana can say wisdom of the body is a matter of core faith for him and have it respected as such; note equal respect for the faith of the nonhomeopaths, and move to the next subtopic. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:50, 21 September 2010 (UTC)
 
:::Howard, I'm glad that you recognize how much of your writing here is not practical to THIS article, as is your arbitrary differentiation between your "assumed" different definitions of the wisdom of the body.  If one believe in evolution, I believes that organisms automatically strive to defend themselves and to survive.  I could quote Hans Selye, MD, PhD, AND Walter B. Cannon (author of the classic text, "Wisdom of the Body") in many places where they assert its presence.  Even MDs recognize its presence, but they tend to ignore it or have a certain disdain when treating people.  Their loss.  In any case, unless you can cite a reputable source for your different definitions, please STOP making assumptions and please stop making up your own defintiions.  [[User:Dana Ullman|Dana Ullman]] 02:50, 22 September 2010 (UTC)
 
::::I need to also say that Howard's assertion that homeopaths do not believe in "etiology" is just one more unfounded assumption he has made (no big surprise). Homeopaths simply have a more sophisticated viewpoint on etiology than Howard and reductionistic scientists do.  For infectious disease, for example, we believe in germs, but we also believe in host resistence.  While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence.  I am beginning to think that Howard is simply unable to understand homeopathy.  Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time.  I look forward to Howard's contributions if he can show real intellectual effort here rather than creating straw men and creating arguments/fights when none exist.  [[User:Dana Ullman|Dana Ullman]] 03:00, 22 September 2010 (UTC)
 
===Strawment Produce text, not attacks===
Cannon, I would note, is a 1963 book, which appears to be aimed at a lay audience. Of course, rather than the sarcastic "I could quote", a far more constructive approach would  be to do so.
 
Please stop yelling about strawmen and propose text. Please stop making sweeping inferences such as the theory of evolution proving the wisdom of the body, which you have yet to define rigorously. "Even MDs" is meaningless without citation, and citation of current and authoritative ones. As I mentioned, it simply does not appear in the indexes major textbooks:  ''Harrison's Principles of Internal Medicine'', the Hopkins ''Principles and Practices of Medicine'', ''Best and Taylor's Physiological Basis of Medical Practice'', or the Guyton-Hall ''Textbook of Medical Physiology.''  My copy of Cecil's Internal Medicine does not come immediately to hand. If it is such an accepted, well-defined concept, one might think that some of the most widely used medical school textbooks might mention it, might one? 
 
'''PROFESSIONALISM ALERT for <nowiki>{{nocomplaints}}</nowiki>''' <blockquote> I am beginning to think that Howard is simply unable to understand homeopathy.  Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time. </blockquote>
 
"While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence [sic]." Nonsense. [[B-lymphocyte]] and [[T-lymphocyte]] immune response are clearly host defenses, although, in some cases, [[immunoglobulin]]s may be provided externally. [[Interleukin]]s  and other [[cytokines]] are signaling mechanisms for host defenses.  [[Granulocyte-macrophage colony-stimulating factor]] deals with improving cellular responses.
 
[[Tumor necrosis factor-alpha]] is a host defense that frequently becomes hyperactive and needs to be returned to safe levels; the area of overactive host defenses is an important one, as in [[anemia of chronic disease]] with the fairly recently recognized roles of [[hepcidin]] and interleukin-6, or, overwhelmingly, in [[autoimmune disease]]. In other words, sometimes the body is about as wise as a teenager being challenged by peers after non-homeopathic dosages of a remedy with the (vivid) memory of ethanol. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:53, 22 September 2010 (UTC)
== Rationalwiki ==
I hope one of you can write an article on the retionalwiki refuting their allegations about CZ as well as the CZ article on homeopathy.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:43, 20 September 2010 (UTC)


:And why, precisely, don't you do it? I have never read Rationalwiki and have no reason to do so. I certainly won't defend the CZ article on homeopathy, because I frankly wish it were gone.   [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:32, 20 September 2010 (UTC)
{{quotation|Homeopathy is alleged to be unfounded by the medical and scientific community. Some studies and meta-analyses have shown that homeopathic medicines have a statistically significant benefits over placebo, but other studies and meta-analyses have shown no difference between homeopathic treatment and placebo. Although many high quality studies have been published in leading conventional medical journals and have shown that homeopathic remedies might be effective in particular conditions, there are not enough replication of this research to establish a reliable body of evidence base for homeopathy.}}


::Unfortunately, as long as there is a CZ with which I work, I will defend its integrity -- and my first view of its integrity is that this article, and the interminable arguments to reach a "consensus" on irreconcilable ideas, continues to damage CZ. I am absolutely unconcerned with anonymous criticisms from wikis or stone tablets. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 10:12, 21 September 2010 (UTC)
There is some fascinating stuff here, and elsewhere in the article, showing how biased rewrites can affect text. I think the rewrite of the first paragraph is an improvement, but the second a disaster of bias. Here, I want to discuss mainly the first sentence of the second paragraph. It makes an interesting case study.


:::I quote: ''I am absolutely unconcerned with anonymous criticisms from wikis or stone tablets.''</quote>  A huge, gigantic, mega 'Hear, hear!' from me, Howard. Well said! [[User:Aleta Curry|Aleta Curry]] 21:39, 21 September 2010 (UTC)
I had "the consensus of medical and scientific judgement is that homeopathy is unfounded.[2]", with a link to Simon Singh's book, a well-known source. Now, I believe I could have written "Most scientists consider homeopathy's theories nonsense and most doctors consider its practice dangerous quackery." That is, I think, objectively accurate. However, I consciously chose not to do that and went for what I think is a neutral formulation.


::::Yes, and 'hear, hear' to Howard's comments on homeopathy above, too. [[User:Ro Thorpe|Ro Thorpe]] 22:14, 21 September 2010 (UTC)
Dana removed the link, which I think is an offence against neutrality. He made the text:


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


I'm afraid that saying a homeopath would call an ambulance when a conventional physician would call one really isn't very informative. If the person using homeopathy is a fully qualified physician, he or she may not even be beginning to use homeopathic principles in the decision. The clinician also may have more facilities and training for emergency interventions.
I changed "equivocal" back to "unfounded". Not only is "homeopathy is equivocal" horrendously ungrammatical, I think even a claim that is "the consensus of medical and scientific is that the evidence for homeopathy is equivocal" would be a serious distortion.


To make the point that is entirely possible to be [[specific about]] either referring or using special care, see [[integrative medicine# Examples from chiropractic |examples from chiropractic]]. I see no reason why a competent homeopath, who claims general health knowledge, can't write a similar list. Alternatively, while we don't have a non-trauma [[triage]] list at CZ, another good starting point would be emergency room, or even ambulance dispatch, criteria for putting a patient into the most urgent category. (thinks of a couple of personal experiences when I was more or less tackled in the ER, and run into the treatment area, while still calmly giving a history). --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:01, 22 September 2010 (UTC)
Nobody corrected my typo, judgment for judgement. So much for quality control.


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


First, precisely what is the value, in other than specific historical contexts, of continuing to insist on the word allopathy being used?  It is frequently used, by supporters of alternative medicine, in a rather sneering way that removes context. Osler, below, uses it in a 19th century concept based on "opposites", which make no more sense in molecular biology than do "similars".
Fascinating. [[User:Sandy Harris|Sandy Harris]] 01:36, 8 December 2010 (UTC)


Sir [[William Osler]] is widely celebrated as one of the true greats of medicine. One reason for the continued popularity of his comments is that they focus on the interaction with the patient rather than try to continue century-old explanations for much better understood phenomena.
:Fascinating indeed.  In due respect, the very fact that you chose to quote Simon Singh, a well-known strong antagonist to homeopathy, is clearly evidence of a strongly biased point of view. Further, the word "equivocal" is the PERFECT word in the light of THIS article that shows both positive and negative trials and meta-analyses.


Material introducing the Osler quote to follow was deleted, as have several variants of:
:If Sandy thinks that the grammar is off, then fix it, just as I fix many of others' sentences...but the fact of the matter is that the LEDE should provide a summary of what is in the article...and the term "equivocal" shows my OBJECTIVITY.
"Other than in some narrow usages (for example, to differentiate conventional medicine from osteopathy), conventional doctors contend that "allopathy" is not a synonym for the paradigms of contemporary medicine, although osteopaths, homeopaths, naturopaths and other alternative medicine practitioners continue to call it allopathy."


There is, however, a revert war on the Osler quote, deleted again: <blockquote>A new school of practitioners has arisen which cares nothing for homeopathy and still less for so-called allopathy. It seeks to study, rationally and scientifically, the action of drugs, old and new."<nowiki><ref>[[Flexner Report]], page 162</ref></nowiki></blockquote>[http://www.carnegiefoundation.org/files/elibrary/flexner_report.pdf]
:As for the term "sympathetic magic," this term is only used by the most extreme antagonists to homeopathy...and I personally cannot remember many references to it in respectable journals and academic reviews.  Further, I had previously quoted Emil Adolph von Behring (the "father of immunology" who discovered the tetanus and diptheria vaccines), and it was HE who acknowledged the link with homeopathy and immunology. To therefore say that homeopathy is "unfounded" is to baste in bias...and sadly, Sandy's statement above is infused in this, which has no place in an encyclopedia.


Note that Osler disapproves of both 19th century-early 20th century allopathy as well as homeopathy; the quote, in broader context, calls both "sects" that will be replaced by science-based medicine. Prior to making this comment, Osler indeed did speak of the superiority of contemporary homeopathy over contemporary allopathy, but the comment, in context, refers to high doses of toxic doses of drugs with no established mechanism of action. <blockquote>A desire to take medicine is, perhaps, the great feature which distinguishes man from other animals.</blockquote>  
:Please note that the term "unfounded" is extreme, especially in light of this article which shows so much connection between homeopathy and modern day (and futuristic) medical thinking.  [[User:Dana Ullman|Dana Ullman]] 06:10, 8 December 2010 (UTC)


The 1905 edition of ''The Principles and Practices of Medicine'' lists only a few drugs as effecitve (e.g., nitroglycerin and amyl nitrite for coronary artery pain, diptheria and tetanuxus antitoxins, and the arsenicals as an improvement in the mercury treatment of syphilis. On the other hand, the text decidedly did not take a avoid-risk-above-all approach as with homeopathy; he was quite aggressive in recommending surgery -- which was also in need of improvement. With the disclaimer that I was a volunteer copy editor, see ''A Brief History of Disease, Science & Medicine'' by Michael Kennedy, a faculty member of the University of Southern California who teaches the first- and second-year Introduction to Clinical Medicine program, another place where one might expect to see the "wisdom of the body" should that be widely accepted in medicine.
:: I disagree with almost everything else you say above, but I do think the von Behring quote, and the Osler quote discussed [[#Allopathy.2C_and_revert_wars_over_Osler_quote|above]] should go back in. [[User:Sandy Harris|Sandy Harris]] 06:48, 8 December 2010 (UTC)


'''Constables''', could we please have enforcement of stopping repeated deletions of the Osler quote about the "new school of practitioners"? --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:18, 22 September 2010 (UTC)
::: All, if we were to go into that much detail on each argument, the article would again outgrow the interest of the average reader.  We have to narrow the focus of this article to an introductory article on homeopathy.  The Osler quotes and entire argument would be quite important and appropriate for the [[History of Homeopathy]] or even the [[History of Medicine]] article. Some of the other points that Dana makes can be made in related pages as well with links back to this one.


:I await constable comment before restoring. This is behavioral; there is no Editor ruling on excluding the quote, and, in any case, it would be unfair to have a ruling from an Editor of only one concerned workgroup. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:46, 22 September 2010 (UTC)
:::The changes that I see to the lead are again driving us back to where we were before. I am quite sure that we will now see a skeptic response that will double the size of the arguments without adding any value.  The bottom line is that the reduction that Gareth has given us states the homeopathic position in a positive light and the science and mainstream positions in a similar light.  He has removed fluff and gruff from both the homeopathic and skeptic viewpoints and boiled the arguments down to their lowest common denominator.  It is neutral, objective, concise and an improvement over the current approved article. The new information can remain in the draft where we can continue to manipulate the text until we get it the way we want it.  


:::Dana, please consider adding your name to the version that I have chosen only as an improvement over the last version and we can continue to adjust according to new information. [[User:D. Matt Innis|D. Matt Innis]] 13:43, 8 December 2010 (UTC)


::Howard, a quick search of the [http://search0.ama-assn.org/search/search?database=public+amnews&query=allopathic AMA website] for "allopathic" gives us some pretty significant current hits.  Looking through the links pretty much shows them calling themselves allopathic often and sometimes specifically.  Maybe it's not meant to be negative. [[User:D. Matt Innis|D. Matt Innis]] 23:57, 22 September 2010 (UTC)
::::Matt, I put a considerable amount of attention to correcting minor and not-so-minor errors in fact and grammar issues. I also feel strongly that the lede MUST be changed from that edition you want to get approved because the term "unfounded" is a black-and-white term that has no place in a good encyclopedia.  Further, that 3rd paragraph is NOT an adequate summary of the review of research described in this article.  I personally thought that referring to the research on homeopathy as "equivocal" was objective and appropriate.  That said, I'm open to something that says that homeopathy is "inadequately founded"...but to say that it is "unfounded" suggests that there is "NO" foundation to homeopathy (and this article shows that this is simply not true. [[User:Dana Ullman|Dana Ullman]] 03:59, 10 December 2010 (UTC)


::To illustrate a few:
:::::Dana, my expertise is not on the science.  That is Gareth's domain.  My donation is assuring that the art and alternative ideas are stated accurately. I think this article does state the homeopathic position in a positive light and you have done a good job stating it. We have to allow the same for the scientific and medical outlook. Surely you agree that most scientists and the majority of the medical community consider homeopathy to be on shaky ground.  They think chiropractic is as well, but most have a distorted view of what we (and you) do. We're not advocating that they are right in this view, only stating what their view is. To state anything else would be wrong. It is up to the reader to decide.
::*''State Medical Licensure Requirements and Statistics—The 2009 edition provides updated information on licensing board requirements for the 54 '''allopathic''' and 13 osteopathic boards of medical examiners in the US and territories.''
::*''Most US '''allopathic''' and osteopathic medical schools routinely incorporate simulation as a standard part of their curriculum.''
::*'''''Allopathic''' medicine – Certification is recognition by one of the 24 approved specialty boards (145 specialty and subspecialties) of the American Board of Medical Specialties (ABMS) that an MD has achieved expertise in a medical specialty or subspecialty. Requirements are: graduation from an LCME-approved or COCA-accredited medical school, satisfactory completion of the appropriate full-time residency training program requirements, an unrestricted valid license in the state or region in which they wish to practice medicine, and passage of a written and/or oral board certifying examination. Certification by an ABMS specialty board is not a requirement to practice in a medical specialty.''
::[[User:D. Matt Innis|D. Matt Innis]] 00:03, 23 September 2010 (UTC)


:::Correct. (<u>my emphasis</u>} The 2009 edition provides updated information on licensing board requirements for the 54 '''allopathic'''  ''<u>and</u>'' 13 osteopathic boards of medical examiners in the US and territories.'' "Allopathic" vs. "Osteopathic" has a specific legal and professional history. Allopathic vs. homeopathic, naturopathic, etc., does not have the same sort of history
:::::Concerning the new study, it's great, but it's too new and it is only one study.  We can't present it as fact, but, again, I defer to Gareth to evaluate the science. I'd be interested to hear what he thinks of your changes concerning the science before I'd change the version number.
:::::[[User:D. Matt Innis|D. Matt Innis]] 05:00, 10 December 2010 (UTC)


:::I'm thinking of one of the most knowledgeable physicians I know. If you were to contrast his approach with homeopathy, would you then call him an allopath? I think Chuck would object, since he's a DO dual-boarded in emergency medicine and family practice, and is widely respected as one of the world authorities in field and disaster medicine. Is the logic here "if you aren't an alternative practitioner, you must be an allopath?" I've noted certain authors to call MDs who use homeopathic methods "homeopaths", just as they do with "homeopaths" with no non-homeopathic training. It might be useful, in this article, to call them "homeopathic physicians" in the sense of distinction between "osteopath" and "osteopathic physician." Of course, if the homeopathic physician is a DO, then can they be allopathic? :-)  
Matt, I agree with you on most of what you say above.  However, when the new draft says that homeopathis is "unfounded", this is VERY different than saying that it is on "shaky ground." To me (and I assume most others), the lede should be a summary of what is below...and that 3rd paragarph is an inaccurate summary of that.  [[User:Dana Ullman|Dana Ullman]] 15:06, 10 December 2010 (UTC)


:::Is this really taking us to any useful place? For me, this article is the litter box of CZ, which must be visited frequently by its users, and maintained only slightly less frequently by those responsible for it. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:09, 23 September 2010 (UTC)
== EC decision pending ==


The [[CZ:Editorial Council|Editorial Council]]  is currently discussing a motion to approve the [http://en.citizendium.org/wiki?title=Homeopathy/Draft&oldid=100737927 revision as of 16:32, 5 December 2010] of the Homeopathy draft. The deliberations in connection with this can be followed on the [http://locke.citizendium.org/cz_ec/DR-2010-004 EC wiki]. [[User:Johan A. Förberg|Johan A. Förberg]] 23:59, 8 December 2010 (UTC)


::::So, what you are saying is that the AMA can call themselves allopaths because they are friends, but if homeopaths call them allopaths, it's a slur. Maybe we should just try to explain that.  [[User:D. Matt Innis|D. Matt Innis]] 00:58, 23 September 2010 (UTC)
== Remarks on version to be approved ==


:::::That's certainly along the right lines. Remember how Hayford said, as I remember, if he calls somone a skeptic, he means it as a compliment, but an alternative medicine practitioner often means the word to be an insult? Readers of this article aren't going to know who uses an emotionally ambiguous word, so why, in a presumably objective article, use a word that has such problematic connotations?
'''Question:''' With respect to all these studies: What about studies on high dilutions vs. moderate dilutions? --[[User:Peter Schmitt|Peter Schmitt]] 00:19, 10 December 2010 (UTC)


:::::With the AMA, it's a little more complex. The AMA grows out of 19th century medicine that ''did'' use a concept of allopathy, but the specific legal conflict was with osteopathy.  In your quote about medical certification, note that it's very distinctly a binary statement of allopath vs. osteopathic '''physician'''. It's not allopath as opposed to everything else. Some of it, in the AMA (representing, as I remember, around 30% of US physicians), is historical.
'''Homeopathic response''':
<s>
* "This review of research also found '''that the''' 21 "high quality" '''studies''' testing homeopathic medicines '''had a more beneficial effect''' than a placebo," ? </s> Sorry, wrong version.  
* "the 8 largest trials of homeopathy showed that '''no?''' benefits," --[[User:Peter Schmitt|Peter Schmitt]] 01:48, 11 December 2010 (UTC)
* "Several studies that had been defined as "high quality" by Linde et al. (1997) were not defined '''by?''' high quality by Shang "
--[[User:Peter Schmitt|Peter Schmitt]] 00:24, 10 December 2010 (UTC)


:::::Consider, Matt, the AMA legal battles with chiropractic. Again, it was a binary dispute between two approaches. The language may have included allopath, but the context was not-chiropractic.
'''Safety''':
* "it would be better for mankind-and all the worse for the fishes." This should be an mdash. --[[User:Peter Schmitt|Peter Schmitt]] 01:01, 10 December 2010 (UTC)


:::::I certainly think it's fair to say that when the average physician or biomedical scientist is called an allopath by someone who does not use a scientific model, they find it insulting. This also gets into the purely silly, as an MD who uses any homeopathic techniques, logically, would be a homeopathic allopath. A non-physician homeopath, though, can't be an allopath as well. I suppose there could be (US) homeopathic osteopathic physicians, but I don't think you could be a homeopathic osteopath in the UK, other than dual licensure. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:14, 23 September 2010 (UTC)
'''Scientific foundations? '''
* In brief, for homeopathy to receive serious scientific consideration, there must be plausible explanations for:
** how an ultradiluted solution can have any specific biological activity
** by what biological mechanism could the specific nature of a remedy be recognised
Style: the second line continues the first, the third line is an inedependent question.


::::::Perhaps when a homeopath uses the word allopath, they just mean those that do not treat with similars, or "homeopathically", regardless of whether they are conventional physicians, or osteopaths, or chiropractors, or traditional chinese practitioners.  How about we just make that clear, because there isn't really a better word.  Besides, if conventional scientific medical physicians don't use the old allopathic methods, then we aren't really talking about them. They are off the hook.  [[User:D. Matt Innis|D. Matt Innis]] 02:37, 23 September 2010 (UTC)
<s>
* "a remedy diluted to more than 12C was assumed to all probability to contain not a single molecule of the original substance. <br> However, new research has confirmed that even extremely diluted homeopathic medicines contain ponderal doses of the original substance"
This needs some explanation -- how much diluted? What is meant by "ponderable" -- is this in contradiction to the first part?
</s> Sorry, wrong version. --[[User:Peter Schmitt|Peter Schmitt]] 00:15, 11 December 2010 (UTC)


:::::::There has been entirely too much use of it in a sneering way for me to let anyone off the hook. I've always thought it elementary human courtesy to assume that it's a personal choice about how one wants to be addressed. Obviously, I'm dating myself, but when Cassius Marcellus Clay wanted to be known as Muhammad Ali, I thought it was his concern.
* "hormesis(the phenomenon" there is space missing before the bracket
--[[User:Peter Schmitt|Peter Schmitt]] 01:24, 10 December 2010 (UTC)


:::::::What the homeopaths mean, therefore, is essentially irrelevant to the self-identification of other groups. It's fair for them to say "non-homeopath", which is self-evidently accurate. Non-homeopath seems infinitely better than allopath, and avoids conflicts such as calling a DO an allopath, or a US-licensed MD who uses homeopathy a homeopathic allopath. Both groups can contain psychopaths. Now meditating on the possibility of a homeopathic osteopathic pathologist  who did a residency under the traditional allopathic American College of Pathology.--[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:55, 23 September 2010 (UTC)
::Peter, I'm not clear what you mean by "moderate" doses, though doing clinical studies that compared different doses would require very large numbers of patients. Most research simply compares ONE dose with a placebo (or with a conventional Rx).


::::::::I'm not saying that homeopaths are off the hook. I'm saying that homeopaths are not talking about conventional medical physicians because <s>they</s> conventional medical physicians are not "allopaths" in the true sense of the word - conventional medicine is off the hook from being included as "allopaths". That is what we need to make clear. [[User:D. Matt Innis|D. Matt Innis]] 13:10, 23 September 2010 (UTC)
::The 2nd point under "Homeopathic Response" should replace the word "by" with "as".


(undent) But what is gained by saying that homeopaths use the term allopath, often in a negative way, rather than simply saying homeopaths and non-homeopaths?  The AMA issue is not relevant as its history shows the issue was very clearly osteopathy v. allopathy as used at the time, roughly, of the Flexner Report.  Essentially, the distinction is largely historic, just as referring to the Commonwealth of Massachusetts rather than the State of Massachusetts. How the state received its charter from the English crown is not part of American jurisprudence, but the old name is given as a courtesy to the Commonwealth.  Insisting on calling people, who don't want to be called allopaths, is not courteous. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:03, 23 September 2010 (UTC)
::It seems that many people here (and elsewhere) use the word "plausible" in different way.  Normally, plausible does not mean PROVEN, but just a possible explanation.  There ARE possible explanations for homeopathic medicines in all doses, though there are no "proven" explanations for them in all doses.  


:Analogy: I've heard that the word "nigger" is not infrequently used by black people among themselves, but they object to others' using it. [[User:Peter Jackson|Peter Jackson]] 17:01, 23 September 2010 (UTC)
::"Ponderable" doses means that there is "something there" in the dose, and I referenced a new study from one of India's leading scientific institutions that shows that there IS something measurable in homeopathic potencies, even at 30C and 200C (that is 30 to the 100th power and 200 to the 100th power).   [[User:Dana Ullman|Dana Ullman]] 03:43, 10 December 2010 (UTC)


::Expansion:  the word "nigger", a word so highly charged and offensive as to generally not even be spoken or written about except euphemistically ('the "N" word'), is used with varying frequency by ''some'' (emphasis important, she says emphatically) black people among themselves and/or in public.  Usage varies; in common parlance it seems restricted by socio-economic class and level of education (I very much doubt the participants in various Black American professional conferences employ the word, unless for humourous or ironic effect, even among themselves) BUT it is also used for dramatic or ironic effect (think rappers) and no one objects to such use in historical context or literary use (''The Irish are the Niggers of Europe'')
Peter,
::Every single Jewish joke I have ever heard was told to me by a Jew.  I mean it; I am not in the habit of exaggerating on such matters.  That notwithstanding, I have never repeated the vast majority to ''anyone'' - not my mother, not my husband, no one, not because I cannot trust those people, but because I found the jokes unfunny and offensive, the religion of the persons who told me is completely immaterial.
* "This review of research also found '''that the''' 21 "high quality"....  
::My point? 
**sentence is in the latest draft and not in the nominated version
::1. Context is everything.
::2.  The fact that someone else uses a term self-referentially does not stop it being a slur when flung at them by an outsider.
::[[User:Aleta Curry|Aleta Curry]] 06:15, 24 September 2010 (UTC)


:::I agree: the word 'allopath' is a slur. It is also obscure jargon: how many people have heard of allopathy who have never heard of homeopathy? [[User:Ro Thorpe|Ro Thorpe]] 22:51, 24 September 2010 (UTC)
* the '''by''' can be changed to '''as''' with a copyedit once the article is approved.
* "it would be better for mankind-and all the worse for the fishes." This should be an mdash.
**these can be changed as copy edits once approved.
* "a remedy diluted to more than 12C was assumed to all probability to contain not a single molecule of the original substance. <br> However, new research has confirmed that even extremely diluted homeopathic medicines contain ponderal doses of the original substance"
**Is not in the nominated version.
:::: Ooops sorry -- it seems that (while reading it) -- I happened to change versions without noticing it. I'll have to reread it. --[[User:Peter Schmitt|Peter Schmitt]] 09:39, 10 December 2010 (UTC)


'''Scientific foundations? '''
* In brief, for homeopathy to receive serious scientific consideration, there must be plausible explanations for:
** how an ultradiluted solution can have any specific biological activity
** by what biological mechanism could the specific nature of a remedy be recognised
Style: the second line continues the first, the third line is an inedependent question.


::::Pseudoscientist a slur. Crank a slur.  Do you really thik there is something wrong with being an Allopath? [[User:D. Matt Innis|D. Matt Innis]] 23:07, 24 September 2010 (UTC)
***purely a style issue.


:::The people who use the word are homeopaths: from them it is a slur. I'm quite happy to be treated by allopaths, whom I call doctors. [[User:Ro Thorpe|Ro Thorpe]] 00:12, 25 September 2010 (UTC)
[[User:D. Matt Innis|D. Matt Innis]] 04:30, 10 December 2010 (UTC)


::::But we are not homeopaths, we are editors. Your complaint, then, is that this article sounds like it is written by homeopaths.  That can be remedied and still use the word allopath - which is an accurate description of what homeopaths think they differ from.
'''Regulation'''
::::I added the part about [[Heroic medicine]] to illustrate what allopathy was back then.  You must realize that in 1799 George Washington died while under the care of a Heroic medicine doctor.  This triggered the search for less aggressive ways to treat as they became very unpopular:
* "any commercial operation - such as" The hyphen should be an mdash
::::*Hahnemann named his system of health care "homoeopathy" (meaning "like disease") - but most people now spell it "homeopathy" - and coined the term "allopathy" ("different than disease") to refer to the conventional medicine of the day, Heroic medicine. Heroic medicine was known for its use of highly toxic compounds to combat disease and resorted to blood letting and leeching as methods to reduce the fever of illness.  
* "Most homeopaths are not medically-trained" Better without a hyphen?
::::[[User:D. Matt Innis|D. Matt Innis]] 00:26, 25 September 2010 (UTC)
* "the instruction '''to "to''' consult a doctor if symptoms persist". " There is a "to" too many.
Matt, of course, these are minor quibbles (style, grammar, typographical). They do not concern approval, but they should be considered nevertheless.
And since this is not the top revision they cannot be corrected directly.
Sorry for confusing versions!
--[[User:Peter Schmitt|Peter Schmitt]] 10:18, 11 December 2010 (UTC)
::No problem for the confusion; it's totally understandable.  You get a feel for part of our problem where draft versions change so quickly in different places.  It is difficult to endorse a version that has changes with which you agree, but others that you don't. It's easier to find a version that I can endorse and improve again from there.  Copyedits such as you describe are still very much appreciated and can be made to the approved version, as you are aware. [[User:D. Matt Innis|D. Matt Innis]] 23:19, 11 December 2010 (UTC)


:::The word 'allopath' in its historical context is fine - I think that has already been established. (By the way, I don't think 'heroic' should be capitalised.) [[User:Ro Thorpe|Ro Thorpe]] 00:52, 25 September 2010 (UTC)
=== Clarification ===


::::(edit conflict - I'll look at Howard's response momentarily)
With moderate vs. high dilutions I wanted to address the difference between, say, 3-5D and 12C. Does this difference enter the trials? Are there different results. (The arguments against 12C cannot be used against 3D.)
::::Then what are we arguing about.  There was never any other use. I'm fine with [[heroic medicine]], but as Nancy Sculerati used to say, "..there is a time to use Medicine and a time to use medicine, there is time to use Chiropractic and there is time to use chiropractic."  This felt like a time to use Heroic!  But, I won't argue dog names, you're the expert with the language! :) [[User:D. Matt Innis|D. Matt Innis]] 01:10, 25 September 2010 (UTC)


:::::Thanks! I remember Ms Sculerati, MD. Eighteenth-century prose or any-century verse, perhaps she meant... [[User:Ro Thorpe|Ro Thorpe]] 02:04, 25 September 2010 (UTC)
I don't have problems with the word "plausible". I only addressed the style: "explanations for: how ... can have ..., by what ... could ..."


--[[User:Peter Schmitt|Peter Schmitt]] 10:48, 11 December 2010 (UTC)


(undent) Yes, I agree.  I have no problem with using "allopath" in context with Hahnemann, when the methods of the allopaths of the time had no theoretical basis. I have a significant problem that homeopaths still call conventional physicians allopaths. Now, today, bloodletting is quite appropriate in the narrow indication of excessive red cells in [[polycythemia vera]], or as an emergency measure for [[pulmonary edema]]. Leeching, of a very minimal sort, is a gentle way to remove congested blood after plastic surgery. In each of these techniques, though, there is a very specific reason for the procedure, and care not to take too much blood.


When allopath is used by a homeopath, it sounds like a slur.  Now, I shall pause to say that in a staff role, I will call an anesthesiologist a gas-passer, and observe that the three hardest years of an orthopedist's career are the fourth grade. This is not necessarily a wise form of address by outsiders. Maybe we need some homeopath jokes, as I certainly know enough physician jokes. :-)
:I've brought this point up myself; that there are homeopathic treatments that do have measurable amounts of product.  I think we have improved some on this, but we could still be more clear.  Unfortunately, the research on these products appears to be lacking in one way or the other as well, but I stay tuned to listen for more evidence to the contrary.  I haven't seen any, yet. The section on hormesis did hint that there were some effects at these 'low dilutions' that were measurable.  Although the research remains interesting, the sum total is still probably not yet convincing. [[User:D. Matt Innis|D. Matt Innis]] 23:19, 11 December 2010 (UTC)


If, Matt, you say there are no more allopaths in the 19th century sense, then the modern comparison is moot. If one accepts the homeopathic argument that present practice is allopathy based on "opposites", you're simply wrong -- many treatments supplement a deficient natural mechanism, while others indeed do try to destroy a causative factor that has relatively little to do with symptoms. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:04, 25 September 2010 (UTC)
== Comment by Anthony.Sebastian ==


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


:Again, then what are we arguing about.  There is no modern day use of allopath in this article.
== To Dana ==


:Good thing I don't say that there are no more allopaths in the 19th century sense because I would hate to be wrong, though I am a lot. [[User:D. Matt Innis|D. Matt Innis]] 01:15, 25 September 2010 (UTC)
Dana,
:I'm not happy with your last edit to the draft, in which you have added the sentence I removed again, but shall refrain from arguing about it. I must quote Shakespeare's Julius Caesar here though, "Et tu Dané? Then fall scissor".—[[User:Ramanand Jhingade|Ramanand Jhingade]] 14:23, 10 December 2010 (UTC)


::Reviewing the article, two uses of allopathy are historic (Kent's might be clearer about that), and then it appears, inappropriately I think, in the title of a Shang article but that's a legitimate quote.
::Dana, I've made some changes and I hope you can go through them before you approve what the others are proposing that Gareth, Matt and you approve.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:41, 11 December 2010 (UTC)


::We would have far less of a problem if the talk page were far more focused.  There have been uses here of allopath as a synonym for conventional medicine, with warnings about the latter. Unfortunately, much of the commentary does not suggest or remove text. (Note that I still don't have a ruling on reverts of the deletion of the Osler quote).
==APPROVED Version 2.0==
=== A Decision by the Editorial Council ===


::Can we agree, then, that allopathy does not belong in the article as a general description of science-based medicine, and simply move on? The argument about licensing boards is irrelevant since it dealt not with homeopathy, but with allopathy as an antonym to osteopathy, and has a historical context. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:23, 25 September 2010 (UTC)
The Editorial Council has decided by unanimous vote that the [http://en.citizendium.org/wiki?title=Homeopathy/Draft&oldid=100737927 revision of this article as of 16:32, 5 December 2010] by [[User:D. Matt Innis|D. Matt Innis]] shall be approved.


:::Sure, let's stay focused.
The reasoning of the Council can be viewed at the EC wiki, [http://locke.citizendium.org/cz_ec/EC-D-2010-006 EC-D-2010-006] [[User:Johan A. Förberg|Johan A. Förberg]] 19:41, 13 December 2010 (UTC)
:::I can agree to use allopathy where it is appropriate, which does not include being a synonym to modern conventional medicine, because that would be inappropriate, but not because it is a bad word. That would be like not using the word chiropractor because some people like to use chiropractic physician.  They both have appropriate places. [[User:D. Matt Innis|D. Matt Innis]] 01:48, 25 September 2010 (UTC)


::::We don't use the term allopath as a slur, but one of the reasons is that it is short for, 'conventional, western, medical doctor'. Most alt. med. practitioners (osteopaths, naturopaths, chiropractors etc.) continue to use the term allopath, so can we mention that here?&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 14:56, 25 September 2010 (UTC)
The Approved version includes [http://en.citizendium.org/wiki?title=Homeopathy&diff=100740341&oldid=100740318 copyedits discussed above and one ambiguous and unverified sentence is removed]. [[User:D. Matt Innis|D. Matt Innis]] 01:40, 14 December 2010 (UTC)


== "Rebound" is used inappropriately ==
<div class="usermessage plainlinks">Discussion for [http://en.citizendium.org/wiki?title=Homeopathy/Draft&oldid=100737927 Version 2.0] stopped here. Please continue further discussion under this break. </div>


There is a long list of citations, following one sentence, which purport to suggest the "rebound effect" is a common medical term. It is not; these appear to be articles that simply use that ordinary English word, but not in any well-defined manner.  On checking [[Medical Subject Headings]] for "rebound" as a keyword, there is no hit, although  there are three disambiguation terms that contain "rebound". The word does not appear in the index of ''Goodman & Gilman's The Pharmacologic Basis of Therapeutics'' (9th Edition).
<hr><br>


This is not to say that the word is not used in medicine.  On physical examination, "rebound tenderness" describes pain that takes place after the examiner puts pressure on an area, usually the abdomen, and then releases the pressure. "Rebound" is commonly used to describe increased nasal congestion when topical vasoconstrictors have been used too frequently on the nasal mucosa.  Rebound is also exhibited by participants in medical school basketball teams.
== What the hell? ==


I recommend the discussion of rebound be deleted, insofar as it is purported to be a medical concept. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:28, 23 September 2010 (UTC)
I thought all 3 editors, Matt, Gareth and Dana were supposed to approve the draft, before it gets approved. Is there a change in policy?&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:16, 14 December 2010 (UTC)
:Please read the section just above -- it ought to be very clear: the Editorial Council made a formal decision that that particular version was to be Approved, and *ordered* the Constabulary to do so. The EC is responsible for ALL content in the CZ project -- this falls under that responsibility. We will now be considering what to do with the Draft version. The Secretary of the Editorial Council, [[User:Hayford Peirce|Hayford Peirce]] 17:14, 14 December 2010 (UTC)


:A simple review of the article on "Rebound effect" on wikipedia references MANY current studies that have verified its reality AND modern acceptance. I'm glad that Howard at least referenced one good text in this instance, but it is clear that just one reference in this case is not enough.  http://en.wikipedia.org/wiki/Rebound_effect  [[User:Dana Ullman|Dana Ullman]] 10:54, 23 September 2010 (UTC)
== Removal of Singh ref from draft is misguided ==


::Again, it seems difficult to get across that Wikipedia is not a relevant authority under CZ policy. As long as the only mention of the term is in individual articles using the word, as long as no major pharmacology or internal medicine text discusses it as a general subject, and it is not in [[Medical Subject Headings]], it does '''not''' have widespread acceptance. Cytochrome clearance has widespread acceptance. Zero- and first-order metabolism has wide acceptance. Michaelis-Menten competitive inhibition has had wide acceptance is being refined.
Dana Ullman seems to have removed the Singh footnote from the draft because he's an "antagonist" or something. What silliness. The point of the footnote is to establish, as the main article puts it:


::Simply waving hands and referring to Wikipedia is not giving even even one good reference.
: The consensus of medical and scientific judgment is that homeopathy is unfounded.


::It's not my job to prove your point by finding general discussions of rebound, as opposed to, for example, the descriptive use of the ordinary word rebound in dealing with sedative-hypnotics or nasal vasoconstrictors. A reference, preferably from a good pharmacology text, that gives a definition of rebound would be general acceptance would be something of proof. My pharmacology texts don't use it. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:03, 23 September 2010 (UTC)
Whether you think Singh and Ernst are "antagonistic" or not, the source does just that. It argues that homeopathy is unfounded from a medical and scientific basis. To fully justify it, you'd have to get a whole stack more sources, but this is not difficult.


:::Howard, I did not chose to provide a link to wikipedia to copy any information for our article. I chose to link to wikipedia because it has a good list of references to some journals such as SCIENCE and many medical journals, and this body of work CONFIRMS that a rebound effect is widely recognized in medicine. {{nocomplaints}} [[User:Dana Ullman|Dana Ullman]] 02:44, 24 September 2010 (UTC) 
Let's see...


::::A reference to a pharmacology textbook that states "rebound" is a general concept would be nice, not just that the word is used in a narrative. It can be useful as a word in narrative, to describe dosage over time, as are terms such as saturation, tolerance, etc., but I still challenge anyone to provide a specific reference that it is considered a basic pharmacological mechanism such as competitive inhibition.   [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:09, 24 September 2010 (UTC)
* [http://www.nhs.uk/Conditions/Homeopathy/Pages/Introduction.aspx NHS]:
*: Homeopathy is a type of complementary and alternative medicine (CAM). CAMs are treatments that are not based on conventional scientific theories.
* [http://www.nature.com/nature/journal/v446/n7134/full/446352a.html Nature]: "Degrees in homeopathy slated as unscientific"
* The Evidence Check report and plenty of media reports on it e.g. [http://ibnlive.in.com/news/homeopathy-unscientific-bad-medicine-brit-panel/110539-17.html]
* The British Medical Association vote against homeopathy
* The many sources on Wikipedia that say homeopathy is scientifically unfounded


:::::I've removed the sentence in question, not because of the doubt about rebound, but because it make the assertion that homeopathy uses that effect in its treatment.  I think it is misleading to suggest that this is how remedies work without references. So I brought it here:
Now, Dana and Ramandand may protest about this. That's fine. They can disagree with it all they like and invoke the bogeyman of Big Pharma or evil skeptics or "antagonists" (critics tend to be antagonistic you know...). They believe homeopathy works. What they seem to not understand is that the article must contain sufficient resources to point out that the current consensus on homeopathy is that it is scientifically implausible and lacks clinical efficacy. You may disagree with the conclusion, but the point of the article must be to point out how things are, not how you fervently wish them to be.


:::::*Recent research has shown that some conventional drugs, which are normally used to do something, can lead to the opposite effect, when stopped - a rebound effect<ref>{{cite journal |author=Bhanji NH, Chouinard G, Kolivakis T, Margolese HC |title=Persistent tardive rebound panic disorder, rebound anxiety and insomnia following paroxetine withdrawal: a review of rebound-withdrawal phenomena |journal=Can J Clin Pharmacol |volume=13 |issue=1 |pages=e69–74 |year=2006 |pmid=16456219 |doi= |url=http://www.cjcp.ca/pdf/CJCP_04-032_e69.pdf}}</ref><ref>{{cite journal |author=Kales A, Scharf MB, Kales JD |title=Rebound insomnia: a new clinical syndrome |journal=Science (journal) |volume=201 |issue=4360 |pages=1039–41 |year=1978 |month=September |pmid=684426 |doi= |url=}}</ref><ref>{{cite journal |author=Kirkwood CK |title=Management of insomnia |journal=J Am Pharm Assoc (Wash) |volume=39 |issue=5 |pages=688–96; quiz 713–4 |year=1999 |pmid=10533351 |doi= |url=}}</ref><ref>{{cite journal |author=Tsutsui S |title=A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia |journal=J. Int. Med. Res. |volume=29 |issue=3 |pages=163–77 |year=2001 |pmid=11471853 |doi= |url=http://openurl.ingenta.com/content/nlm?genre=article&issn=0300-0605&volume=29&issue=3&spage=163&aulast=Tsutsui |last2=Zolipidem Study |first2=Group}}</ref><ref>{{cite journal |author=Hohagen F, Rink K, Käppler C, ''et al.'' |title=Prevalence and treatment of insomnia in general practice. A longitudinal study |journal=Eur Arch Psychiatry Clin Neurosci |volume=242 |issue=6 |pages=329–36 |year=1993 |pmid=8323982 |doi= 10.1007/BF02190245|url=}}</ref><ref>{{cite book | last = Reber  | first = Arthur S. | authorlink = | coauthors = Reber, Emily S. | title = Dictionary of Psychology | publisher = Penguin Reference | date = 2001 | location = | pages = | url = | doi = | id = | isbn = 0-140-51451-1}}</ref><ref>{{cite journal |author=Kales A, Soldatos CR, Bixler EO, Kales JD |title=Early morning insomnia with rapidly eliminated benzodiazepines |journal=Science (journal) |volume=220 |issue=4592 |pages=95–7 |year=1983 |month=April |pmid=6131538 |doi= |url=}}</ref><ref>{{cite journal |author=Lee A, Lader M |title=Tolerance and rebound during and after short-term administration of quazepam, triazolam and placebo to healthy human volunteers |journal=Int Clin Psychopharmacol |volume=3 |issue=1 |pages=31–47 |year=1988 |month=January |pmid=2895786 |doi= 10.1097/00004850-198801000-00002|url=}}</ref><ref>{{cite journal |author=Kales A |title=Quazepam: hypnotic efficacy and side effects |journal=Pharmacotherapy |volume=10 |issue=1 |pages=1–10; discussion 10–2 |year=1990 |pmid=1969151 |doi= |url=}}</ref><ref>{{cite journal |author=Hilbert JM, Battista D |title=Quazepam and flurazepam: differential pharmacokinetic and pharmacodynamic characteristics |journal=J Clin Psychiatry |volume=52 Suppl |issue= |pages=21–6 |year=1991 |month=September |pmid=1680120 |doi= |url=}}</ref><ref>{{cite journal| journal =Pharmacopsychiatry | year =1989 | month =May | volume =22| issue =3| pages =115–9| title =Can a rapidly-eliminated hypnotic cause daytime anxiety? | author =Adam K | coauthors =Oswald I| pmid =2748714| doi =10.1055/s-2007-1014592}}</ref><ref>{{cite journal |author=Garland EJ |title=Pharmacotherapy of adolescent attention deficit hyperactivity disorder: challenges, choices and caveats |journal=J. Psychopharmacol. (Oxford) |volume=12 |issue=4 |pages=385–95 |year=1998 |pmid=10065914 |doi= 10.1177/026988119801200410|url=}}</ref><ref>{{cite journal |author=Rosenfeld AA |title=Depression and psychotic regression following prolonged methylphenidate use and withdrawal: case report |journal=Am J Psychiatry |volume=136 |issue=2 |pages=226–8 |year=1979 |month=February |pmid=760559 |doi= |url=http://ajp.psychiatryonline.org/cgi/pmidlookup?view=long&pmid=760559}}</ref><ref>{{cite journal |author=Smucker WD, Hedayat M |title=Evaluation and treatment of ADHD |journal=Am Fam Physician |volume=64 |issue=5 |pages=817–29 |year=2001 |month=September |pmid=11563573 |doi= |url=http://www.aafp.org/afp/20010901/817.html}}</ref><ref>{{cite journal |author=Riccio CA, Waldrop JJ, Reynolds CR, Lowe P |title=Effects of stimulants on the continuous performance test (CPT): implications for CPT use and interpretation |journal=J Neuropsychiatry Clin Neurosci |volume=13 |issue=3 |pages=326–35 |year=2001 |pmid=11514638 |doi= |url=http://neuro.psychiatryonline.org/cgi/content/full/13/3/326}}</ref><ref>{{cite journal |author=Vitiello B |title=Understanding the risk of using medications for attention deficit hyperactivity disorder with respect to physical growth and cardiovascular function |journal=Child Adolesc Psychiatr Clin N Am |volume=17 |issue=2 |pages=459–74, xi |year=2008 |month=April |pmid=18295156 |pmc=2408826 |doi=10.1016/j.chc.2007.11.010 |url=http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2408826&blobtype=pdf |format=PDF}}</ref><ref>{{cite journal |author=Maizels M |title=The patient with daily headaches |journal=Am Fam Physician |volume=70 |issue=12 |pages=2299–306 |year=2004 |month=December |pmid=15617293 |doi= |url=}}</ref>; homeopathy uses the rebound effect of a remedy to stimulate natural healing.
If the pro-homeopathy editors are unable to edit according to the CZ [[CZ:Neutral point of view|Neutral point of view]] policy, I do hope the Editorial Council and Constabulary will deal with them appropriately. —[[User:Tom Morris|Tom Morris]] 21:36, 14 December 2010 (UTC)
:::::[[User:D. Matt Innis|D. Matt Innis]] 01:36, 25 September 2010 (UTC)
<nowiki>Insert non-formatted text here</nowiki>


(undent) Looking through these articles, "rebound" is used in a general way. For example, in a discussion of methylphenidate in childhood attention deficit hyperactivity disorder, "A rebound effect may occur in the late afternoon or early evening, when the medication wears off in about one-third of the children with ADHD.56 With this rebound effect, symptoms of ADHD become evident again as the child becomes more irritable and noncompliant."
== A Request for a Decision to the Editorial Council about blanking the Draft article ==


Assume, for the sake of argument, that rebound is being used in a general way.  Does this establish an equivalency between rebound and similars?  I think not. Methylphenidate (Ritalin), given to a normal subject in a high dose, will indeed cause agitation and hyperactivity. It is characteristic of patients with ADHD, however, that medium to high -- not homeopathic -- doses calm them. The "rebound" occurs when the drug levels drop. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:16, 25 September 2010 (UTC)
An official Request for a Decision has been made to the Editorial Council to blank the Draft article in its entirety and to also Archive the present Talk page. The Request is now in the Seconding stage. It may be read at:


:Yes, its usage here seems to be a generic jargon. All that may be necessary is to say that ".. homeopaths refer to this as a rebound effect."  But we would have to explain what they are calling a rebound effect.  It appears that:
http://locke.citizendium.org/cz_ec/DR-2010-006
:*"Homeopath's consider that perhaps their remedies work by pushing the body's physiology slightly further away from homeostasis - a balanced state.  As a result, the body's healing mechanisms respond by working harder to return to normal.  They refer to this as a "rebound effect.""
:[[User:D. Matt Innis|D. Matt Innis]] 02:38, 25 September 2010 (UTC)


::Howard, Dana has already mentioned that all homeopathic remedies need not be more dilute than 'Avogadro's no.'; even if these refs aren't mentioned in 'Textbooks', they are well known in medical circles - CZ allows such a mention, so I suggest we have the sentence, with you inserting a critique after it. Matt, we only treat a sick person and not someone who is already healthy (homeostatic), so we should not explain it the way you stated above.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 14:40, 25 September 2010 (UTC)
The Secretary of the Editorial Council [[User:Hayford Peirce|Hayford Peirce]] 22:32, 14 December 2010 (UTC)

Latest revision as of 04:11, 17 December 2010

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


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

Next step

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

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

EU and labels

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

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

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

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

In the section "A typical homeopathic visit":

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

should probably read

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

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

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

Case study on objectivity

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

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

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

The current draft has:

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

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

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

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

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

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

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

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

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

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

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

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

EC decision pending

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

Remarks on version to be approved

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

Homeopathic response:

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

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

Safety:

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

Scientific foundations?

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

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

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

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

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

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

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

Peter,

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

Scientific foundations?

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

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

      • purely a style issue.

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

Regulation

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

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

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

Clarification

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

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

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


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

Comment by Anthony.Sebastian

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


To Dana

Dana,

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

APPROVED Version 2.0

A Decision by the Editorial Council

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

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

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

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


What the hell?

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

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

Removal of Singh ref from draft is misguided

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

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

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

Let's see...

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

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

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

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

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

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

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

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