Talk:Homeopathy/Archive 9

Homeopathy

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Dec 10th 2008 -Jan 3rd 2009

Some ground rules (please do not delete from top of the page)

Here are some brief comments that I hope will help reinforce our ground rules. I'm sorry I don't have time for more detailed engagement right now. Some Citizens have complained to me that homeopathy's advocates on this page are tending to purge criticisms. On this I will absolutely put my foot down. You may not do so. You may maintain that (and say in the article how) homeopaths reject the criticisms, but you may not simply delete points, and source material, simply because you disagree with them or you think they are misinformed. If you have a strong disagreement about a published criticism, you should voice it in the article, rather than removing the criticism. There may be exceptions to this rule, but (I understand) not in several recent cases in the present article. Of course, the "reply, don't delete" rule assumes that a source and criticism are important enough from the point of view of homeopathy's critics to be included. While they can have input of course, this is not ultimately a matter that homeopathy's defenders are best placed to decide. The word "skeptic" should not be used, pejoratively, to identify those who reject homeopathy in the article. If there is a need repeatedly to identify the skeptics of homeopathy, you may not use a term that the skeptics themselves reject. You must find a mutually agreeable term. I suggest "mainstream physicians." "Allopaths" won't do, either, although it certainly can be introduced, and it should be. It should not be necessary for me to point out that the article can neither endorse nor roundly condemn homeopathy. The article does not take a stand; it presents both (or all) sides on all controversial issues it presents, and leaves it up to the reader to decide for himself. The article does not endorse a position. Precisely because homeopathy happens to be a minority viewpoint when it comes to the health issues it discusses, criticism of homeopathy does not belong in a separate "criticisms" section of the article. I have my doubts whether there is any need for a "criticisms" section at all, but I can't say so until I've read the current version, which I haven't done. Selective and uncritical reporting of references is contrary to CZ's neutrality policy: this makes it appear that we officially think the literature says such-and-such, when there is legitimate disagreement about whether it does say that. When, therefore, a "skeptic" raises a question about a statistic such as 18% of Americans, we must absolutely deal with this question. I am very uncomfortable publishing information about the percentage of Americans who accept homeopathy, when it has not been made clear what "acceptance" amounts to in the survey that was performed. Therefore, either this essential interpretive information must be included in the article, or the information about the statistic must be excluded. Anything else would be, quite simply, misleading and unscientific. More generally, on a topic with this much disagreement, we simply cannot add heaps of studies and statistics to the article without adequate explanation and without critical responses where such may exist or be possible. Uncritical reportage of the results of disputed studies has an inherently biasing effect. Finally, I want to underscore that if anyone repeatedly reverts significant parts of the text without explaining and defending his actions here on the talk page, I will consider banning that person. I would ask those who are following the article more closely to make a list of such unexplained reversions, and provide it to me privately. On the basis of such information I will either issue a warning or, if the problem is very serious, a temporary ban. Let me finish on a positive note. Despite the amount of struggle over this article, or perhaps because of it, this article has grown and in many ways improved, and other articles have spun off. This is a good thing. As I like to say, if everybody is equally frustrated, that means that work is getting done and the article isn't too biased one way or the other. Still, if we can all follow the above ground rules, I think we'll get along quite a bit better. --Larry Sanger 16:22, 20 October 2008 (UTC) I want to add another point. While I do not endorse Wikipedia's inane and abusable rule "assume good faith," I do want to suggest that we need something a little like that. I might say, instead, "Assume your opponent is reasonable enough to be open to compromise." If you make that assumption, you will yourself be much more likely to propose a compromise, and to be open to one. Then, if the other person shows himself to be completely closed to any compromise, whether yours or any that he might propose, the matter suddenly becomes much clearer. Then you can contact me, saying, "Look, I proposed a compromise, so-and-so did not accept it or propose any compromise in response. What do we do?" --Larry Sanger 15:17, 24 October 2008 (UTC)

History of

Having noted the above debate, it seems that Paracelsus DOES have enough of a role in the history of homeopathy to deserve a mention, if not in the intor, in the relevant section. So I've put him back there. I do think those removing him earlier should have considered doing this kind of 'constructive' change rather than the 'deletionist' kind. In fact, the link ot the 'history of' page is not very impressive - there is little new materail here, and indeed much of the current page's scientific interests are rehearsed. The c&a medicine page is not in fact a page indicating or even hinting at the wide variety of information and material there is on this to be (eventually) found, but rather a brief and IMO crude dismissal of the topic. We can surely do better than this!Martin Cohen 21:09, 10 December 2008 (UTC)

Martin, in due respect, you must provide references (and credible ones) to your ideas about Paraselsus being the "father of homeopathy." When I previously deleted this info in the intro, I provided concerns about this which you still have not answered. Please answer them here before going to the article. Paraselsus' concept of "signature" is a very primative understanding of the principle of similars. Hahnemann brought a specific experimental method to this principle, learned the value of potentization, and coined the word. There is only one "father of homeopathy" and Paracelsus ain't him. Dana Ullman 06:15, 11 December 2008 (UTC)

I did add back in some info about Paracelsus. I have also deleted a bunch of inaccurate info about Galen and 4 humors. Actually, most medical historicans assert that Galen and the humors had nothing to do with homeopathy or the principle of similars (it is mostly the use of opposites!). This section is much improved, though it needs more improvement. By the way, for people interested in history, the History of Homeopathy needs a lot of work, especially because very little info there is on history...it is mostly a review of homeopathic theories. Eeeks. Dana Ullman 07:36, 11 December 2008 (UTC)

(written while Dana was writing the preceding response:)

I have googled Paracelsus+Hahnemann. My conclusion is that the influence of Paracelsus on Hahnemann, a very erudite person, was major. There are far more resemblances between P and H than this (signatures). Should we say "father of homeopathy"? perhaps, with a cautionary note. Should we have references, and well researched article on Paracelsus that we could link to? Sure. But the last things that are needed are hasty deletions and fragmentations of this article. Yes, CZ is an hypertext. But we're still creating this homeopathy article! The scientific aspect of homeopathy was transferred to a controversial article, "memory of water", without proper examination of the non-controversial aspects of the materials science of water or homeopathic preparations, described in Martin Chaplin's website. Now, we are supposed to give up Paracelsus, until Martin Cohen can find references and back "his" case? This is not collaboration. There are no material scientists who have studied water in CZ. There are no specialists of Paracelsus. But there are some persons who want to learn.

Returning to fragmentation. What's happening here is a process that took place in Diderot's Encyclopedia. The subarticles contain tools and info to question and actually rewrite the root article. Encyclopedists found that it was a good way to transmit info that would have been rejected if they had been in top topics. Who decides, in CZ, when it is appropriate to put things about the material science of water as an ancillary topic, under a highly controversial heading ("memory of water"), thus effectively presenting homeopathy as a scientifically undefendable superstition or hoax? Who decides that Paracelsus, the magician, the alchemist, cannot be associated with Hahnemann?

Asking the question answers it.

Matt Innis pointed out this problem in the forum discussion about neutrality notes. I agreed, and Martin had comments along those lines. How is it possible to have a Neutrality note about an article if it is the absence of some things in the article that is considered (by some) as the bias? This is the problem of demarcation.

When I first began researching on the materials science relevant to our case, the motto was Matt's "let's take our time and do it right". So I work, with very little help (but some support). Suddenly, I get the message that the article should get approved sooner than later. My work gets transferred elsewhere, I give up... and weeks later I notice that the timeline has changed: people are taking their time again.

What if I told you that Paracelsus' influence seems to require more "let's take our time and do it right" and less "give your references, build your case, and don't forget you're not an expert"?

I'm going to tell you why I chose to embark in this homeopathy article adventure. I wanted to test if CZ can handle scientific controversies. Yes, if and only if we take our time, discuss, build closer collaborative ties, and invite experts (by recruiting or through readings).

--Pierre-Alain Gouanvic 07:57, 11 December 2008 (UTC)

The most important thing is to accept what an expert says.e.g.I had a tough time inserting the sentence that homeopaths treat acute bronchitis, until Gareth looked up the Net and found it to be true. I think Larry should look into this.�Ramanand Jhingade 08:42, 11 December 2008 (UTC)

Pierre-Alain and anyone else, I welcome whatever references you provide that verify that Paracelsus was the "father" or "founder" of homeopathy, but I insist that this should not be placed in the article until there are good references for it and there is consensus on the Discussion pages. I can tell you that I am fairly knowledgeable about Hahnemann's history and have written and published widely on the subject, and I cannot remember a single incident in which Hahnemann quoted or referenced Paracelsus. Even if someone were to find some specific statement, it is unlikely that it would be adequate enough to supercede Hahnemann as being the father or founder of homeopathy. I've said enough on this subject and don't plan to say more until substantial evidence is provided. Dana Ullman 23:51, 11 December 2008 (UTC)

Rolled back "if it doesn't work"

I rolled back "if it doesn't work", which Ramanand added to a sentence about when to call for conventional medicine. The context suggests that homeopathic treatment should always be the first form of therapy, and conventional physicians called in only "if it doesn't work." Ramanand did not qualify the context to indicate if the homeopath has any medical training, to make a rational choice if the condition is one in which there could be immediate danger without appropriate treatment.

Versions of this point have, to an extent, been an edit war. Dana made the reasonable point yesterday that with cholera, the medical training of most homeopaths would say that oral replacement therapy (ORT) must come before everything else, other than IV fluid replacement if the patient cannot swallow. Not replacing fluids and electrolytes, in acute cholera (as defined by the WHO and CDC), is quite likely. ORT is hardly a toxic conventional drug: it contains water, sodium, potassium and carbohydrate. A quite useful improvised ORT, for developing countries, is to take the water in which rice boiled, put in a spoonful of salt, and mash part of a banana or pour orange juice into it (both are rich in potassium).

The idea of trying homeopathic treatment first for everything is at the center of the fears by conventional medical physicians and scientists. If the practitioner is dual-trained and chooses, with informed patient consent, to try a homeopathic remedy for a non-life-threatening condition, that's between the patient and practitioner. Indeed, if, in that case, the homeopathic remedy worked, I'll call that patient choice.

Gareth and Chris, I believe, have tried various rewrites saying that the chief concern about safety is that inappropriate delay in providing medical treatment can cause dangerous delays. An unqualified "if it doesn't work" is simply not acceptable from the medical standpoint, unless, for example, Dana is correct that most homeopaths are medically as well as homeopathically trained. I still would like to see sourcing on that training, and I believe Dana agreed that there are unlicensed practitioners. It is the latter, practicing pure homeopathy, that are of the greatest medical safety concern. Howard C. Berkowitz 16:12, 11 December 2008 (UTC)

Homeopaths do use homeopathy as the first line of treatment, so we should have that matter I inserted or remove the whole sentence.—Ramanand Jhingade 10:10, 12 December 2008 (UTC)

I'm hearing a fundamental difference between Dana and Ramanand. Dana suggests most homeopaths are medically trained, and, if a patient presents with a potential medical emergency, they will use nedical techniques within their scope of practice and refer otherwise, quite possibly complementing the medical with homeopathic remedies. If, for example, such a practitioner, especially one already part of a multidiscipinary team, wanted to use homeopathic methods as part of the treatment of a condition such as fibromyalgia, I might be comfortable with that.

Ramanand seems to be saying that India has both conventional medical and classical homeopathic training and certification, and that 10 percent of the population uses homeopaths as primary care providers. It is this 10 percent that especially concerns me, as Ramandand has offered no information that students in the homeopathic curricula get thorough medical training. Howard C. Berkowitz 11:24, 12 December 2008 (UTC)

Deletionism and do people read things properly before deleting?

Dana has deleted my Paracelus point although reinstated him later, for which I thank her - magnaminous!

She also announced problems with the history of Homeopathy page - exactly the problems I just pointed to above - did she read that? At least we agree t here is a problem. The page could be said to be advancing... but my mina concern is certainly not being addressed. I don't say everyone has to change their way of operating, but I do think there needs to be some restraint on deleting contributions, as Pierre hints too, as though a 'rule' has been established and certain persons are entitled to interpret and enforce it on the page.Certain persons are entitled to do just that. See belowHoward C. Berkowitz 21:38, 11 December 2008 (UTC)

Here is the text again:

"Paracelsus (1493-1541) is considered by some as the "founder" of homeopathy, and is also credited with popularizing the theory "of signatures". According to this, the medicinal use of plants is revealed in exterior signs such as colours or shapes. "

There is nothing remotely controversial about this, and I changed the text to ensure that. Dana can look it up for herself in any reputable homeopathic source.

(Here's a typical reference: "The doctrine of signatures was a purely philosophical notion until Boehme's predecessor, the alchemist Paracelsus, had applied it to medicine ..." from page 27 of The American Institute of Homeopathy Handbook by Edward, M.D., D.Ht. Shalts (Paperback 2005))

I don't think the contribution is terribly original, or interesting. It is however relevant to the history of the subject and leads us towards other areas. I'd like to see it reinstated, and if not, I shall raise it as an issue on the forum for general discussion. Many historical, cultural and 'traditional' aspects of homeopathy are are neglected in this page which, to repeat, is adopting an inappropriately narrow and exclusive 'scientistic' approach. Most of the debate paraded here as 'central' is 'marginal' - Dana makes that point too, in a way, in her edit here:

"Although homeopathy is practiced by medical doctors, other health professionals, and consumers in virtually every country in the world, homeopathy is not accepted by majority of mainstream medical doctors or conventional scientists today."

Calling this 'improving the sentence" is disingenuous, though, Dana, and I don't think it improved the article. It struck a political note where one would expect a neutral tone. However, as I say, Dan in my view raises the issue of the gap between the 'scientific-medical' and the 'health care' or indeed general public perspectives. The homeopathy article should not be constructed from the first approaches perspective at the expense of excluding the others. At the moment, it is - and so is the 'history of homeopathy page', and the 'alternative and complementary medicine' page. We have to accept new perspectives in order to start to balance the pages. A start would be by restoring Paracelus to his proper place, which, whether it is as elevated as 'some' claim - is certainly important. Martin Cohen 21:25, 11 December 2008 (UTC)

Please do not roll back a revert without discussion on this page, and usually Editor approval. Revert wars are regarded quite severely here.

Incidentally, Paracelsus must have some powerful techniques, as you appear to have performed gender reassignment on Dana. Seriously, I'm not sure what you mean by a "first approaches" perspective, but the general philosophy of CZ is not to insist on bringing in every idea that might bear on a subject. Actually, under CZ, "certain persons are entitled to interpret and enforce it on the page". They are called Editors for the workgroup. Dana is a Healing Arts Workgroup editor, and, whether I agree with him on the deletion or not, I do know, as an Editor in other workgroups, that his ruling will stand and be reinforced unless more Editors disagree, or his ruling is disapproved by the Editor-in-Chief or Editorial Council (of which I am a new member, but I'm not guessing).

Who is "we" such that "we have to accept new perspectives?", and who will compel "us"? Howard C. Berkowitz 21:38, 11 December 2008 (UTC)

Martin, I asked for a reference for your "fact," and the reference that you provided did NOT verify it. In the future, please do not reinsert deleted comments, creating an edit war, until there is some consensus from the Discussion page. Your assertion that Paracelsus was the father or founder of homeopathy is not simply "controversial," it doesn't seem to be true. I showed good faith by incorporating what you were trying to say about Paracelsus, and I will continue to try to collaborate with you and others to create the best possible article. Dana Ullman 23:19, 11 December 2008 (UTC)

As an aside, i thought that Dana is male? Chris Day 02:55, 12 December 2008 (UTC)

That had been my impression as well, but do remember that Martin is an advocate of alternate positions. :-) Howard C. Berkowitz 03:12, 12 December 2008 (UTC)

Geez, all you gotta do is go to User:Dana Ullman, where Mr. (Dr.?) refers to himself a gazillion times as "he" or "him" or some such.... Hayford Peirce 03:18, 12 December 2008 (UTC)

I rest my case. Chris Day 03:21, 12 December 2008 (UTC)

Friendly amendment further improving precision?

Dana,

I like your last

Some of the principles of homeopathy has been utilized in some form for thousands of years, but its basic principles were first methodically set out by a German physician, Samuel Hahnemann (1755�1843), who observed that a medicine sometimes evoked symptoms similar to those of the illness for which it was prescribed.

Would it be even more precise to say,

"Some of the principles of used in homeopathy has been utilized in some form for thousands of years. The term homeopathy and its formal definition came from German physician, Samuel Hahnemann (1755�1843). His key observation was that a medicine sometimes evoked symptoms similar to those of the illness for which it was prescribed, and his key theory was that very small doses of such a medicine would heal a matching set of symptoms."

I'm not happy with ...and his key theory..., but I think breaking up the first sentence both makes it clear what Hahnemann actually did, as opposed to what influenced him. Since this is not rocket science, I'll borrow the analogy that Kostantin Tsiolkovsky can't be said to have originated rocket-propelled space flight, since it was Robert Goddard that actually developed a rocket engine designed, as his book was titled, A Method of Reaching Extreme Altitudes. Short-range gunpowder rockets that stayed at low altitudes had been around for centuries, and Tsiolkovsky and others talked about an evolved rocket that could go to high altitude, but it was Goddard that defined the actual technique. Paracelsus might have described a goal, but did not, as far as I know, speak of the key concept of similars.Howard C. Berkowitz 23:09, 11 December 2008 (UTC)

Thanx Howard. However, Hahnemann did not simply define "homeopathy;" he created the methodology underlying this system of healing. Further, we would be more precise if we said that his "experiments" (not simply "observations"). Therefore, my suggestion would be:

"Some of the principles of used in homeopathy has been utilized in some form for thousands of years. The term homeopathy, its formal definition, and the methodology of this medical system derived from German physician, Samuel Hahnemann (1755�1843). Hahnemann's experiments on human subjects discovered that a medicine will elicit a curative effect on people who exhibit the similar symptoms to which the substance causes in overdose. Later, Hahnemann developed a specific pharmacological method, called potentization, that significantly reduces the size of the dose of the medicine while seemingly increasing its therapeutic effects." Dana Ullman 23:42, 11 December 2008 (UTC)

No problem. It was, I thought, essential, aside from anything else, to say explicitly that he was the first to use the term, and then explain his other work. Whether or not one believes in the paradigm, it is only fair to say, as you did, that he both defined "homeopathy" and "potentization". Paracelsus made some observations and connections, but it was Hahnemann that defined an actual system. Is there any serious argument that we are not working from Hahnemann's definitions in this article? We may have arguments about efficacy and other matters, but, up to a couple of days ago, there didn't seem to be much disagreement about the starting point.

While some may want to bring other ideas in CAM into this article, it's fair to say that several people have been struggling for precision for months, and, until there is consensus there, insistence that alternate perspectives need to be considered now, in this article, takes us back to a starting point. It may well be that some of the alternative perspective ideas could go into the complementary and alternative medicine, but this article is about a specific system. Even in the CAM article, the CZ way to do things is building on what is already there, or, if one really wants to tear apart what is done, either reaching a consensus that is needed, or waiting until it's fairly obvious no one is concerned with changes. I have torn apart articles, but I gave plenty of warning I was doing so. Howard C. Berkowitz 23:55, 11 December 2008 (UTC)

We need to mention Paracelsus in a way that doesn't diminish the importance of Hahnemann.—Ramanand Jhingade 10:46, 12 December 2008 (UTC)

MCI

I'm providing a ref to the Medical Council of India web-site to show that the Dept. of AYUSH is a separate entity.—Ramanand Jhingade 11:37, 12 December 2008 (UTC)

Potency/Dilution

I've started putting together a table at Homeopathy/Catalogs. However, I'm not sure which are the standard potencies that are used. I added LM as 1LM 2LM and 3LM just as experimentation but maybe 1LM (or just LM?) is the only one that is in standard usage? I saw a few references to 10L, 20L and 50L, are these commonly used? Are there others? Some notes on the reasons for the different dilutions and their relationships would be interesting to our readers, I think. Chris Day 15:38, 12 December 2008 (UTC)

Those potencies are designated, 'L/1', 'L/2', 'L/3', 'L/4', 'L/5', 'L/6', etc., with 'L/3', 'L/6', 'L/9', 'L/12' being the most used.—Ramanand Jhingade 07:00, 13 December 2008 (UTC)

In due respect, I have never seen reference to "L" potencies. I assume that you mean "LM" potencies. "LM" refers to 50,000, and it refers to dilutions of 1:50,000 (instead of 1:10 or 1:100). Dana Ullman 17:48, 13 December 2008 (UTC)

Really, I found several references to L potencies (or in some case M); 1:1000 dilution? LM potencies i also saw used with a Q nomenclature. This was part of the reason i thought some kind of table would be useful to clear up the inconsistencies as well as explaining which are the major ones used and for what purposes. Chris Day 21:07, 13 December 2008 (UTC)

Dana, it was the LM potencies I was refering to.

Chris, I believe it's best you leave all that to a homeopath, because an M (1000) potency is different from an LM potency, which is different from a Q potency (mother tincture).—Ramanand Jhingade 07:34, 15 December 2008 (UTC)

Well that's what I was suggesting. I was asking you to fill in the blanks and make it relevant. All I did was add some things I found on the web. Chris Day 10:07, 15 December 2008 (UTC)

Reference Integrity

A reference from an Indian Government site states that homeopathy is recognised as one of the Indian 'National Systems of Medicine'. Another contributor is recverting this to 'Alternative Systems of Medicine'. The issue is simple - what does the reference say? it says National not Alternative. So please, either find a reference which says something different, or else leave this alone, but do not make a lie of the reference by changing the wording to be inconsistent with what the reference says. This rule is absolute - never change the wording of a directly referenced statement in a way that makes it inconsistent with what the reference says.Gareth Leng 16:23, 12 December 2008 (UTC)

Please check your email. D. Matt Innis 16:52, 12 December 2008 (UTC)

If some aspect of this continues, it would be nice to know, briefly, what India means by "national system" (traditionally Indian, such as ayurvedic?), and where conventional medicine fits. An article, comparable to National Center for Complementary and Alternative Medicine, for Indian National Systems of Medicine could be a nice addition to CZ. Howard C. Berkowitz 19:19, 12 December 2008 (UTC)

The ref mentioned is the official web-site, so I don't think I can find a 'better' ref. There is a mention of, 'these complementary alternative systems of therapeutics' at the end of that page, so I hope you can look into it. You (Gareth) and possibly Dana should correct that.—Ramanand Jhingade 07:20, 13 December 2008 (UTC)

Here's what I am reading from [1], with emphasis. "In 1948, the Committee by Planning Commission in 1951 and the Homoeopathic Pharmacopoeia Committee in 1962 testify to this. At the instance of the recommendation of these Committees, the Government of India have accepted Homoeopathy as one of the national System of Medicine and started releasing funds for its development" A different sentence says "Homoeopathy in India enjoys Government support along with the other systems of medicine because Government is of the view that presence of all these complementary alternative systems of therapeutics offers a much wider spectrum of curative medicine than is available in any other country."

I can see this as confusing. The home page of this section says that"The Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) was established as Department of Indian Systems of Medicines and Homoeopathy (ISM & H)".

• The first direct quote says "homeopathy is one of the national systems of medicine." It doesn't say the national systems are alternative, or even what the systems may be.
• The second sentence includes "Government is of the view that presence of all these complementary alternative systems of therapeutics" It doesn't use the word "national" with "alternative", although they are on the same page
• Nowhere on either page is any mention of conventional medicine.

So, I agree that the reference never calls homeopathy an "alternative", but rather a "national", system of medicine. The reference does say that homeopathy is among a recognized set of CAM, but doesn't use the word "national" Putting the two sentences together, one can infer homeopathy is a national systems and the national systems, which do not mention conventional medicine at all, are complementary and alternative. In other words, it never explicitly calls homeopathy one of the alternative systems of medicine, but I can see how one could infer it from the text. "National" does seem the only phrasing that can be supported with a direct quote, although it can be inferred, but not quoted, that homeopathy is one of the government-recognized systems of medicine.

Could everyone restate what this comment and reference are trying to establish? I think it's fair to say that a branch of the Indian government recognizes homeopathy as an established method of care, and it is of the national standards. The specific department, like the U.S. NCCAM, is only concerned with alternative medicine. The reference never explicitly calls homeopathy an alternative system of medicine, but it suggests that it is. It's just not a site that supports the "alternative system of medicine" as a direct quote.Howard C. Berkowitz 10:41, 13 December 2008 (UTC)

badly worded sentence in lede paragraph that can lead to confusion

The third sentence: "Although homeopathy is practiced by medical doctors, other health professionals, and consumers in virtually every country in the world, homeopathy is not accepted by the majority of mainstream medical doctors or conventional scientists today." is badly worded and potentially confusing.

It first says that "homeopathy is practiced by medical doctors", then goes on to say that it "is not accepted by the majority of mainstream medical doctors". This makes the reader say, "Whuuuh?"

The easiest solution is to rewrite the first part to say "homeopathy is practiced by some medical doctors" by adding the word "some". If, of course, this is what the sentence actually intends to say. Since I don't think that pure homeopaths are called "medical doctors", I *suppose* this is the intended meaning. If not, then the entire sentence should be clarified by rewriting. Hayford Peirce 19:11, 12 December 2008 (UTC)

I agree, Hayford. That entire paragraph seems repetative. We are going to lose most readers by the second paragraph. It needs consolidating. D. Matt Innis 03:23, 13 December 2008 (UTC)

Good edit. Dana Ullman 17:43, 13 December 2008 (UTC)

Matters arising

First of all, this page is too long, can 'the page's owner' archive some of it, please?

Secondly, Dana, my apologies for misstating your gender, a false assumption about the name 'Dana'.

A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

It is a matter of easily verifed fact that 'some people' consider Paracelsus to be the 'Father of Homeopathy'. Here is another such 'person':

http://www.angelfire.com/in4/alchemy2084/paracelsus.html

Robert Coon, the author in this case, is what we might call an 'unreliable source' - except in one thing - he knows his own opinion. He is a 'lectureer' in homeopathy, and he thinks that Paracelsus is the Father of ... am I making a point clear?

I am open to the idea that the page would be 'overstating' his claim, if we used the formulation I first of all offered, but my statement is NOT factually incorrect.

A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

Much of the world considers homeopathic medicine to be 'real' medicine, I understand (without being there at the time, so 'some' may dispute it) that Gandhi said this:

"Homeopathy cures a larger percentage of cases than any other method of treatment and is beyond doubt safer, more economical and a most complete complete medical science."

A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

My benchmarks are these:

The page should reflect these: Homeopathy is a subject much larger than the Western European 200 year old invention version ... Paracelsus belongs 'somewhere' in the 'true' history of homeopathy.

Here is a link to some well-founded comment on that. I suggest Dana incorporate some - or perhaps a Constable would confirm that I and others will be allowed to without having our entire contribution swiftly and indiscriminately deleted (as happened to me here originally) and followed up with inaccurate and ad hominem comments on the talk pages.

I still believe we can work together on this topic! The page is NOT at a 'final stage', it is woefully lop-sided and and much needs to be done. Recently, despite all that is said above, the page has made progress - hasn't it? Martin Cohen 22:06, 12 December 2008 (UTC)'

Hi Martin, you "own' this page! Just cut and paste the sections that you want to archive into this page. You can do this any time you like. Just remember to keep active sections on this page. D. Matt Innis 03:32, 13 December 2008 (UTC)

Martin, I've just now read your comments above--I'm afraid I must ask you please to refrain from attempting to characterize your fellow contributors. That's common practice on WP and many online forums, but not here. You can think of us as a "moderated discussion group" similar to old-fashioned mailing lists with rules about collegial behavior.

On the more substantive matter of whether Paracelsus has an important founding role in homeopathy (is that the issue under dispute? I really couldn't tell precisely), I think that your case would benefit greatly if you were to lay out more evidence in greater detail. This is especially obvious if a true expert about homeopathy in our midst, Dana, expresses considerable skepticism about a text you describe as "nothing remotely controversial." (Obviously, it was, or it wouldn't have been deleted, eh?) All this discussion would be rendered unnecessary if you were to (1) state exactly the minimum claims you want to ensure are in the article, and (2) find some credible sources supporting those claims, if after exact formulation they still turn out to be controversial.

On the other hand, if the one sentence about Paracelsus now in the article is enough for you, then no more needs to be said on the subject, I guess (please! :-) ). --Larry Sanger 04:14, 18 December 2008 (UTC)

The role of Paracelsus reflects the view one takes of homeopathy - that is to say, if one looks at it from a cultural and historical perspective or from a 'scientific' perspective as a medical 'method'. To some extent then, yes ther eis m09re to be said about Paracelsus's role in medicine, but given the page's overall character, perhaps not here. In a few wrods - yes, one sentence will do! Martin Cohen 13:20, 18 December 2008 (UTC)

More on Paracelsus

"A text on pharmacology in nursing credits Paracelsus with exerting �a profound influence upon the medical beliefs of his time and of succeeding centuries� (Bergersen and Goth, 1979). In Remington�s Pharmaceutical Sciences, Higby (1990) lauds Paracelsus for �sparking the growth of the modern pharmaceutical sciences.� Countless textbooks, handbooks, encyclopedias and dictionaries (general and special), and monographs give him similar credit. Other sources refer to him as the �Father of Toxicology.� Furthermore, his name appears as a significant figure among voluminous numbers of works on homeopathy, natural medicine, alternative medicine, and botanical studies. A Web-based Paracelsus mailing list is part of a �health web system,� and the Paracelsus Healthcare Corporation runs the Bledsoe County General Hospital of Pineville, Tennessee."

from http://www.mindfully.org/Pesticide/Paracelsus-Dose-ToxicologyOct01.htm

Martin Cohen 22:08, 12 December 2008 (UTC)

Clearly, Dana was aware of such evidence, and no doubt what stopped him was (1) a failure to get very clear on what the article should say about Paracelsus, and (2) if what you want to say is that many informed people think he is a founder of homeopathy, offering evidence on that precise point is necessary. The items you listed above don't support the precise claim in my (2) here. They support the less controversial claim that Paracelsus is lauded and discussed a lot by homeopathic practitioners and medical doctors alike. -- But it appears that in the days since the above was written, a suitable conclusion was arrived at. It's a shame that so much digital ink was spilled over just one sentence. --Larry Sanger 04:34, 18 December 2008 (UTC)

There is no question that Paracelsus is a major historical figure in medicine. Paracelsus belongs in any history of medicine article that covers his era.

This is not a general article on the history of medicine. It is on the specific subject of homeopathy. Every available reference says that Samuel Hahnemann created the word, definition, and basic methodology. While it may be in the parthenogenetic sense, that makes him the father of homeopathy. Unless you can find a source that Hahnemann specifically said his methodology is built on that of Paracelsus, there is no more justification for saying he is the father of homeopathy than was Hippocrates, Galen, Aristotle, or Bucephalus.

Further, a Healing Arts editor has made, I believe, an editorial ruling on fact, under CZ rules, that Paracelsus was not the father of homeopathy. Again under CZ rules, that ruling stands, unless it is overruled by at least two Workgroup-specific Editors, the Editorial Council, or the Editor-in-Chief. These rules are in existence precisely to stop the sort of endless content arguments that characterize Wikipedia. I agree with Dana on very little, but, as an Editor in other workgroups and as secretary of the Editorial Council, he seems to have made a straightforward ruling with which I agree. Gareth Lang is the other active Editor in this article; you may ask him as well, but I doubt you are goig to get a different answer.

If necessary, that ruling can be enforced, by the Constabulary. May I suggest that you drop the Paracelsus argument before enforcement measures are taken? I'd note that this is a very difficult article for reaching consensus, and the Paracelsus argument is a tangent from several months of work. If anything, people are trying to reduce the article size, putting, again by CZ policy, some materials into subarticles. Please try to understand the rules and customs of this community and not try to substitute your own. If there are policy issues with which you disagree, you may variously address them to the Editor-in-Chief, the Editorial Council, or discuss them on the Forums.

This is a talk page for Homeopathy. An authorized Editor has ruled that Paracelsus is not within its scope. Further argument about Paracelsus is not appropriate here. Is there anything ambiguous about that? Howard C. Berkowitz 22:41, 12 December 2008 (UTC)

We need to mention Paracelsus in a way that doesn't diminish the importance of Hahnemann.�Ramanand Jhingade 07:50, 13 December 2008 (UTC)

I'd like a look at this by Constables, then. Not on the claim Howard has just unhelpfully rehearsed despite my long explanation to the contrary just above, but on the 'actual' issue:

I think the Homeopathy page should include Paracelsus, who 'some' people consider to have had a major influence on the subject. I have given a couple of explicit examples and references to indicate this, I think it would be fair to say that Ramanand and Pierre have supported the notion (from their more expert perspectives) that Paracelsus is part of the history of homeopathy, and that Dana himself has allowed a mention on the page. Yet Howard is stating - again - as a 'rule':

"This is a talk page for Homeopathy. An authorized Editor has ruled that Paracelsus is not within its scope. Further argument about Paracelsus is not appropriate here."

If this statement is left unaddressed, I fear it undermines the basic principles of CZ.

THREE notes:

1. The original edit offering 'Paracelsus IS the Father of Homeopathy' has been amended, willingly, by me, as indicated above - it is a view held by some, and can be argued for, but the'decision' of Dana and others here has been accepted and no one is arguing that that phrase should be used. It's repetition by Dana and Howard is misleading and seems to be intended as a 'strawman' tactic.

2. The current text on the page (as edited by the major contributors to this page) now INCLUDES a reference to the role of Paracelsus, which in 'content' terms, seems satisfactory to me. However, Howard's statement attempts to set a precedent that would exclude such adjustments.

A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

Constable Response: The question of Paracelsus is a content decision for which there are remedies through the editorial and author conflict resolution processes. I suggest that everyone review them. They are there to allow articles to progress through dissagreements such as these. Constables remain at arms length from these decisions for good reason. There is nothing that asks or allows a constable to stop a citizen from making comments on article or user talk pages so long as they are professional. However, it can become an issue if metadiscussions spread from one article page to another as they become inflammatory and this gets dangerously close to unprofessional behavior. We cannot solve professional disputes on Citizendium, we only report them. Again, use your workgroups. D. Matt Innis 16:09, 13 December 2008 (UTC)

"if it doesn't work" is back again

I see that this sentence has once again been edited to read: "Some physicians, however, still maintain that even benign homeopathic treatment is relatively unsafe, because it might delay effective, conventional medical treatment, if it doesn't work."

I thought it had been agreed, or possibly even ordered, that "if it doesn't work." would no longer be attached. (In any case, if it *is* permitted to stand, it should be rewritten as "does not" rather than "doesn't". Hayford Peirce 19:05, 13 December 2008 (UTC)

That was my understanding. It reappeared at 06:55, 12 December 2008. There was discussion about it a few hours later, but no one actually took it out. That may be nothing but an oversight. Howard C. Berkowitz 19:54, 13 December 2008 (UTC)

Well, it's easy to take out -- I'll do it right now. Hayford Peirce 20:04, 13 December 2008 (UTC)

Hey, I thought I explained that adequately. That sentence needs to be qualified. The, 'if it does not work' conveys the meaning that not all homeopathic treatment is unsafe.—Ramanand Jhingade 07:03, 15 December 2008 (UTC)

How would, 'unless it works' be?—Ramanand Jhingade 07:16, 15 December 2008 (UTC)

How about ""Some physicians, however, still maintain that even benign homeopathic treatment is relatively unsafe, because it might delay more effective, conventional medical treatment." Oh, and a reference for the assertion, of course. Richard Pinch 07:25, 15 December 2008 (UTC)

There's no reference for that quote, so I think it's better to delete that sentence.—Ramanand Jhingade 07:45, 15 December 2008 (UTC)

Dana has 'toned' it and I'm OK with what it says now.—Ramanand Jhingade 07:57, 15 December 2008 (UTC)

I'm going to have to demand, Ramanand, that you leave this text alone in the future. You repeatedly re-inserted this bit, and it was clearly explained that your addition made the statement virtually nonsensical. One iron-clad, absolute rule of wiki editing is that you must not edit sentences in a way that makes nonsense of the point they were trying to make. Obviously, you were trying to "neutralize" the sentence there, which I respect, but you went about it in the wrong way.

The most recent edits to this not only removes your "if it does not work," it even removes "while homeopaths assert there is far greater danger by first using conventional medications due to their questionable efficacy and their side effects." Gareth made these edits. Since he is an editor, you are not free to re-insert that text, which I suspect you'll want to do when you notice it.

If I'm not mistaken, the reason he removed that additional text is that the "Safety" section immediately goes on to discuss those concerns. If you want to make sure the homeopathic view on the safety of modern drugs and vaccines is stated sympathetically (but bearing in mind that the other side must also be stated sympathetically as well), that would be the place, I think. --Larry Sanger 05:17, 16 December 2008 (UTC)

I'm not gonna add/remove anything there now - I'll leave it to Gareth and Dana (I hope they do the needful). My point was that that sentence needs to be qualified. The, 'if it does not work' conveys the meaning that not all homeopathic treatment is considered unsafe.—Ramanand Jhingade 07:18, 16 December 2008 (UTC)

"not even a single molecule" -- why I think this should be restored

I definitely think that to such an extreme degree that in most homeopathic remedies, that, by later understanding of molecular concentration, "not even a single molecule of the original substance remains.", although perhaps in another place in the overall article.

You don't have to discuss the nature or structure of water in order to have this phrase -- it is a well-known argument by anti-homeopathic skeptics such as Martin Gardner and others. And it is one that is pretty easily understood even by people with very little grounding in science.

If you want, you could then add something like, an assertion that homeopaths dispute on several grounds. Hayford Peirce 22:56, 14 December 2008 (UTC)

A possible location could be in the dilutions table at Homeopathy/Catalogs. One problem is that this all depends on the concentration of the orignal mother tincture. Nevertheless we can add in the notes the point at which dilutions to less than one molecule per drop (or percontainer) occurs for most remedies. Chris Day 23:30, 14 December 2008 (UTC)

Isn't it generally assumed that 24X or 12C is the point in which there should be no remaining molecules (beyond Avogadro's number). Homeopaths do not deny that there may not be any molecules in these potencies, but this is like asserting that a magnetic field doesn't exist because a magnetic field does not have any molecules in it (THAT isn't the point). And for the record, a large number of homeopathic medicines that are sold in health food stores and pharmacies throughout the world are in lower potencies, 1X to 23X (or 1C to 11C), which are doses in which it is not proper or accurate to say that there is "nothing" there. Dana Ullman 00:53, 16 December 2008 (UTC)

I think this is the main reason it would be useful in the table, to put some perspective on the different potencies that are available. I think the notes section in the table could have a lot of interesting tid bits that would destroy the flow of the article itself. Chris Day 04:09, 16 December 2008 (UTC)

Representative Remedies table

I originally formatted some existing text about remedies into a table, but, at this point, does the information actually add to the article? We have an article on Oscillococcinum and perhaps someone would like to write an article on some other remedy mentioned in the text (e.g., in a trial). Otherwise, let's either fill it in more solidly, or delete it. Howard C. Berkowitz 03:47, 15 December 2008 (UTC)

Absolutely not

"Where a cause cannot be found, for example a viral attack which does not have a reliable method of testing yet, homeopathy can be more effective."

This is an opinion, possibly a fair one, but has no place in this article. We must not assert efficacy as though it was an editorial judgement. The question of efficacy is one that we are accepting as being in dispute and one that we are leaving to the article on Testing. So please no insertions anuywhere in the text of editorial claims that homeopathy is effective or editorial assertions that it is ineffective. (Though we may report such claims and assertions, judiciously).

To emphasis, any statement in this article that implies that homeopathic treatment has an efficacy above placebo will be disputed. This article must not include any editorial assertion of this form; to include any such statement would be to make an editorial judgement of disputed fact, and I will delete any I see.Gareth Leng 17:37, 15 December 2008 (UTC)

Thanx Gareth. I agree. That said, it may be more appropriate to say: Homeopathy has a history of efficacy in the treatment of 19th century infectious disease epidemics, and because there is modern-day research that has shown efficacy in using homeopathic medicines in treating select viral illnesses, such as influenza, it may be prudent to consider homeopathic medicines as a part of a comprehensive treatment program for viral illnesses.

Also, I haven't looked to see exactly where an editor placed the previous statement (or where Gareth deleted it), but I want to inform others on this site that because a conventional medical diagnosis is not necessary for homeopathic treatment to be determined, homeopathic care can be considered for those patients whose ill-health is not adequately diagnosed or understood. Dana Ullman 01:07, 16 December 2008 (UTC)

I have much less problem with your second paragraph than the first. Especially for diffuse chronic diseases, such as fibromyalgia, where conventional treatment may or may not help, I'd certainly agree that it is only fair to inform a patient that there have been some clinical trials indicating that homeopathy might help. Complementary (I'm not saying alternative) therapies are certainly worth of consideration.

As far as considering homeopathic medicines as part of a treatment program for viral illnesses, I am far less willing to agree with that being in the article, at least with respect to influenzas. We now know immensely more about not just epidemic influenza in general, but the specific extreme virulence factors of the 1918-1920 pandemic. Given that there are finite budgets, I would want to be comfortable that there were adequate stockpiles of the demonstrably efficacious neuraminidase inhibitors, and even the less effective hemagglutinin inhibitors before expending additional resources on homeopathic remedies. Since we do have a good molecular understanding of the pathogenic mechanisms, and we know that Roy's assumptions that went into Oscillococcinum were wrong, I don't think, at least with respect to epidemic influenza, that CZ can justify including "it may be prudent to consider homeopathic medicines as a part of a comprehensive treatment program for viral illnesses." Using homeopathic medications in a viral infection, when there are no known treatments, and it doesn't divert resources, could be patient and clinician choice. There's not much to lose with rabies or Ebola by trying complementary therapies. Howard C. Berkowitz 01:49, 16 December 2008 (UTC)

(Just popping in quickly and probably popping out.) I am confused. Gareth made what I thought was a very definite, clear-cut statement: "To emphasis, any statement in this article that implies that homeopathic treatment has an efficacy above placebo will be disputed. This article must not include any editorial assertion of this form..." Then you, Dana, said: "Thanx Gareth. I agree." And then your very next statement was: "That said, it may be more appropriate to say: Homeopathy has a history of efficacy in the treatment of 19th century infectious disease epidemics, and because there is modern-day research that has shown efficacy in using homeopathic medicines in treating select viral illnesses, such as influenza, it may be prudent to consider homeopathic medicines as a part of a comprehensive treatment program for viral illnesses."

It seems to me that while you say you agree, you are not in fact agreeing with Gareth, or perhaps you misunderstood him (but that would be hard to believe, because he was, as I said, quite clear). Dana, you want the article to say, (a) "Homeopathy has a history of efficacy in the treatment of 19th century infectious disease epidemics" and (b) "in treating select viral illnesses." These seem to me to be precisely two statements that imply that "homeopathic treatment has an efficacy above placebo." Gareth says that such statements "will be disputed" and that we "must not include any editorial assertion of this form." So, Dana, will you please clarify? It seems you should say one of three things. (1) That you think the article should make your statements (a) and (b), but these statements do not imply that homeopathic treatment has an efficacy above placebo. (Explaining that would be a trick!) (2) That you think the article should make your statements (a) and (b), and since these statements do in fact contradict what Gareth said, you are in fact disagreeing with him and were wrong to say you agreed with him. (That would be puzzling.) (3) That, actually, you somehow misspoke or misunderstood and that you didn't mean to assert (a) and (b), but some revised (a') and (b'), which do not imply that homeopathic treatment has an efficacy above placebo. (This seems most promising.) I leave it to you to straighten this out. --Larry Sanger 04:24, 16 December 2008 (UTC)

There are important things that I agree with Dana about. In particular, I agree with him that in the 19th century, conventional medicine was pretty rotten, and their "cures" were often toxic - worse than the disease; conventional medicine at the time sought treatment based on theory - on understanding the disease, but they didn't have much clue, nor did they have a systematic way to evaluate efficacy anyway. I agree that Hahnemann saw this very clearly, he rejected theory, relied on his own judgement and observations of patients, and sought to use the lowest effective doses to avoid side effects. As the drugs actually were ineffective, there was no lowest dose. He was also a humane and insightful health reformer, who promoted cleanliness, good nutrition, careful nursing - and homeopathic hospitals which implemented these and avoided toxic cures did better than conventional hospitals. So they had a history of relative efficacy compared with a frankly counterproductive conventional medicine. But their death rates then do not indicate any efficacy compared with modern active treatments, (he comparison is inappropriate of course). I have no objection to the article stating claims for homeopathy (I have inserted a section on these); my only objection would be to endorsing them; I don't think it's for CZ to say what is prudent and have tried to avoid that - we can say what homeopathy advises and what conventional medicine advises and leave it at that.Gareth Leng 13:51, 16 December 2008 (UTC)

Both sides here have agreed that, "Especially for diffuse chronic diseases, such as fibromyalgia, where conventional treatment may or may not help, I'd certainly agree that it is only fair to inform a patient that there have been some clinical trials indicating that homeopathy might help" and "There's not much to lose with rabies or Ebola by trying complementary therapies". I hope you (Dana) can insert that appropriately.—Ramanand Jhingade 07:48, 16 December 2008 (UTC)

Since you are quoting me, Ramanand, you are incorrectly quoting me. That I might personally agree that it is useful to inform a patient is a general comment on informed consent. That is my personal opinion. I would also insist that the clinician would say there is no evidence that they will help, and going to homeopathy may create false hope.

If I had rabies or Ebola, I would not, myself, accept homeopathic treatment. Instead, I would request ICU support that has, in well over a century, saved one patient with clinical rabies. If I had no response to that, I would explicitly ask for appropriate terminal comfort care, such as high-dose opioids and/or barbiturates. I would not consent to homeopathic treatment. So, when I speak of a hypothetical informing of a patient, that is not "both sides agreeing". It was stated as an option. There are complementary therapies that I would try in otherwise unresponsive fibromyalgia, but, again, I would not consent to homeopathic treatment. Now, if one wanted to inform the patient "There's not much to lose with rabies or Ebola by trying complementary therapies, but there is no evidence they will help, and trying them may simply lead to a more unpleasant death because they are incompatible with terminal sedation," I'm OK with that. Howard C. Berkowitz 13:27, 16 December 2008 (UTC)

I'm certainly willing to insert that homeopathists are willing to treat rabies and Ebola. Not willing to offer advice to patients in any form.Gareth Leng 13:55, 16 December 2008 (UTC)

Thanx Larry for waking me up on my confusing statement. What I meant was that I agreed with Gareth on his rejection of the statement in the article "Where a cause cannot be found, for example a viral attack which does not have a reliable method of testing yet, homeopathy can be more effective." I believe that there should be some research on the homeopathic treatment of a specific condition before we include reference to it. That said, we have given reference here to a Cochrane Report that review four large clinical trials testing Oscillococcinum in the treatment of influenza. There IS a body of research here! As for fibromyalgia, there are two trials here, one of which was published in the BMJ (1989) (this was a double-blind, placebo control trial WITH a crossover...a very impressive trial) and one of which was published in Rheumatology, 2004, which found clinical relevance AND objective changes in EEG readings in homeopathic vs. placebo patients.

We could also say that it may be prudent to consider trying homeopathic medicines in the treatment of conditions for which conventional medicine has no known efficacy, but we need to be very careful on creating this list. We have to word this so that it doesn't sound as though homeopaths claim efficacy for such conditions (unless someone can provide evidence). Dana Ullman 15:12, 16 December 2008 (UTC)

There are two issues here. First, yes, there are studies described as "promising" in comparing homeopathy with placebo in upper respiratory infections. Unfortunately, I don't remember if these were specifically for influenza, and, if so, for which types of the virus.

The second issue, however, would apply specifically to influenza treatment. If homeopathy demonstrably was better than placebo, that is indeed worth reporting.

For true influenza viruses, however, there are conventional medications that have demonstrated efficacy and are in general medical use: the neuraminidase inhibitors zanamivir and oseltamivir, which are effective against both Influenza A and B, and the hemagglutin inhibitors amantadine and rimantadine, effective against A only and to which resistance is being seen. Proper perspective, if discussing influenza, would assess efficacy with respect to the best available conventional treatment, not to placebo alone. Let's not get too enthusiastic about placebo controls when there are accepted means of medical treatment; the general pharmaceutical industry is, properly, being challenged to demonstrate that their new drugs are better than what is already available. "Better" can mean safer, if efficacy is roughly equivalet. Howard C. Berkowitz 15:25, 16 December 2008 (UTC)

Howard, there IS presently reference to this review of research on homeopathy and influenza from the Cochrane Reports (see reference #65). While those conventional drugs may presently be proven to have greater impact on influenza symptoms than homeopathic medicines, these conventional drugs also presently have much greater risks too, especially in comparison with homeopathic medicines. One could also say that heroin gets rid of pain with greater frequency than homeopathic medicines, but many people determine what medicine they want to take in light of the various benefits and risks. For many people, they prefer greater safety in their treatments. Also, there is growing evidence that Tamiflu and other flu medicines are having decreasing benefits as the viruses adapt to them. Dana Ullman 03:28, 17 December 2008 (UTC)

Under the Declaration of Helsinki (see informed consent), it is unethical to give a placebo if an established treatment exists. There are existing treatments for influenza, which is of major pandemic concern. I'm not really interested in handwaving about the possible risks. Either homeopathic remedies are more effective against influenza than neuraminidase inhibitors, the gold standard of treatment, or they are not. In preparing for pandemics, there are resources to stockpile one or two classes of drugs.

While those conventional drugs may presently be proven to have greater impact on influenza symptoms than homeopathic medicines

Thank you. In an influenza pandemic, increased risk of side effects is quite acceptable, if the drug with proven greater efficacy can limit or stop an outbreak. Gareth said

clear and irrefutable evidence for the effectiveness of homeopathic remedies

and that certainly would be the overriding public health consideration in an epidemic.

Oh -- heroin is a safe and effective drug for severe pain. Diacetylmorphine simply crosses the blood-brain barrier faster than morphine, but not as fast as some of the new synthetics. It is banned in the U.S. only for political posturing. Fentanyl and sufentanyl are more addictive by any reasonable standard. Please stop changing the subject. Howard C. Berkowitz 03:50, 17 December 2008 (UTC)

Dana, Homeopathy is equally effective in influenza, as long as one has prescribed the simillimum.—Ramanand Jhingade 07:20, 17 December 2008 (UTC)

I think that Howard has exaggerated the case of "proven" efficacy of conventional drugs by asserting that it is "unethical" to use other treatments for the flu. Please give a notable reference for this specific situation. When we consider the additional risks to these drugs, the ethical equation changes. Further, increased use of these conventional Rx in minor flu symptoms decrease their potential efficacy for more serious flu syndromes as flu viruses adapt to these drugs. There is a case that can be made for how widespread use of these conventional drugs prior to the emergence of a deadly bird flu can have the potential to create public health crisis because such overuse can reduce their benefits if or when the real bird flu hits. Dana Ullman 03:56, 19 December 2008 (UTC)

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A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

Scientific basis

Gareth, while I think I wrote the last bullet under "Scientific Basis of Homeopathy", would you agree it should read:

• clear and irrefutable evidence for the effectiveness of homeopathic remedies, evidence that cannot be explained in conventional scientifically acceptable terms

If the section were not entitled "Scientific basis", I could settle for: clear and statistically significant evidence..." Obviously, there are any number of areas, in conventional medicine, where a treatment works, and either the mechanism remains incompletely understood, or the wrong mechanism was long assumed. As an example of the latter, think of all the approaches to treating gastric ulcers until two Australians figured out the role of Helicopter pylori and earned a trip to Stockholm. I'm not sure where, however, I would move a sentence saying there would be acceptance if the statistical evidence was overwhelming even though the full mechanism was unknown.

Howard C. Berkowitz 18:29, 15 December 2008 (UTC)

Thanks, my phrasing was clumsy and clearly I didn't get the intent across. I meant that we need a) robust evidence that the remedies are effective and b) to be convinced that the efficacy doesn't have a conventional explanation (e.g. the placebo effect). Have a go please if my intent is clearer nowGareth Leng 18:42, 15 December 2008 (UTC)

You were looking at a different aspect than I was; perhaps we need to converge. When you said "conventional means", I wasn't thinking of a placebo effect, but something that was measurable but hadn't been observed before. Hypothetically, if one observed that after a homeopathic remedy was administered, there were reproducible objective changes versus placebo (e.g., creatinine level no longer rising in renal failure, CD4 count increasing in HIV), but no explanation for the mechanism of those changes, one would still have to accept that they were accomplishing something. When you speak of placebo effect, I'm assuming you mean that the placebo arm and the homeopathic arm of a trial had the same results.

Is this closer? The key points are safety and efficacy are demonstrable, without requiring the mechanism to be understood

• clear and irrefutable evidence for the efficacy of homeopathic remedies, evidence that cannot be explained by placebo effects and does show statistical significance of efficacy
• clear and irrefutable evidence for fewer side effects of homeopathic treatment, with equal or better efficacy, than the accepted standard of medical treatment.

I've modified - but not added side-effects; I don't doubt that homeopathy has no side effects.Gareth Leng 14:23, 17 December 2008 (UTC)

Of course, that doesn't solve the problem of comparing, in a statistically meaningful way, when the homeopathic assumption of individualization would seem to imply that there is no concept of an effect that is replicated throughout a treatment cohorts; the idea of a cohort doesn't seem to be acceptable in homeopathic models. The sine qua non is that there has to be a mutually accepted statistical paradigm, such as some being proposed for pharmacogenetics.

Sadly, I am not aware of any research by homeopaths into "how can we define a meaningful controlled trial given our constraints", rather than "we reject controlled trials." As I've mentioned for genomic medicine, this is a problem that is wider than homeopathy — yet the researchers in the new paradigms are trying to find statistical methodology that makes sense. Howard C. Berkowitz 19:18, 15 December 2008 (UTC)

Remedy selection is highly individualised in Homeopathy, so if a person catches cold immediately after getting wet in the rain and if another person catches a cold only after getting wet in the rain everyday for 3-4 consecutive days, the remedy each would get would be different, because their susceptibility/immunity differs. Now having said that, there are enough refs in the article to show that Homeopathy is more effective than 'placebo'.—Ramanand Jhingade 08:19, 16 December 2008 (UTC)

Gareth Leng, a responsible Editor, has ruled that he will not approve a statement, in the article, that flatly says homeopathy is superior to be placebo. When an Editor has made that sort of content ruling at CZ, it becomes CZ policy for the article, unless it is overruled. It may be overrule in one of three ways: two or more relevant editors, the editor-in-chief, or the Editorial Council determines the ruling is wrong.

There is little point in arguing it on the talk page. You need to take find two or more editors to overrule Gareth, get Larry to overrule, or take it before the Editorial Council. My own observation is the articles do not, paraphrasing Gareth, such superiority, establish an unquestionable superiority, but I understand the process well enough that if I disagreed with him, I would be starting an appeal, rather than continuing to argue the point. Howard C. Berkowitz 13:15, 16 December 2008 (UTC)

Just to clear up some things in Howard's comment: While I think two or more relevent editors would certainly apply some pressure, there aren't any rules that suggest that they can or cannot overrule another editor. Currently, this is the status of the the role of editors in conflict resollution in our editorial policy on dispute resolution. D. Matt Innis 14:13, 16 December 2008 (UTC)

Matt, I agree in principle that the rules don't specifically have a provision for overriding, I realize I had a special case in mind. If that unlikely event took place, I'm sure it would wind up in the Editorial Council or some quickly formed community response.

As I read the Approval process, and I am not saying this is completely clear-cut, it would appear that two or more Editors could Approve an article even if another workgroup editor disagreed. I have no idea what would happen if there were only two relevant workgroup editors and they disagreed. You are right that the policy could be more clear; this is my interpretation as an individual contributor.

Nevertheless, I believe one point I made is valid: if a relevant Editor, such as Gareth, makes a content ruling and asked the Constabulary to enforce it, there is no real value to continue arguing it on the talk page. The rational course, at such time, would be to invoke an appeal process. Seriously, is that a fair interpretation? Howard C. Berkowitz 14:30, 16 December 2008 (UTC)

Ahh, I see why you made that assumption - it would appear that two or more Editors could Approve an article even if another workgroup editor disagreed. This is covered in the CZ:Approval Process#Overview where it explains that one editor may remove the ToApprove tag:

• If another editor in the article's workgroup finds that the article is so objectionable that approval, in his considered opinion, should not be granted, then the "ToApprove" metadata is removed by this editor, who puts his reasons for this action on the talk page. (This is a fail safe rule, to prevent the approval of articles that are inaccurate or misleading.)

So there is nothing that dictates that two ediotrs can overrule another. Otherwise, the policy seems to encourage discussions away from the article talk page, perhaps shifting to the workgroup talkpage/emails to editors/the appeals process which your last paragraph illustrates. Hope that helps.

D. Matt Innis 14:58, 16 December 2008 (UTC)

So are y'all suggesting I e-mail Larry, since there are enough refs in the article to show that Homeopathy is more effective than 'placebo'?�Ramanand Jhingade 07:30, 17 December 2008 (UTC)

First, there are not enough references to say, generically, "homeopathy is more effective than placebo." There could be a reference that says that "homeopathy is, with high statistical confidence, superior for placebo in well-defined (e.g., ICD) condition X". Second, if there is a medically accepted treatment for condition X, it is unethical, under the Declaration of Helsinki, to do a placebo-controlled trial, with some specialized exception. The generally accepted standard of proof, when there is an accepted treatment, is that the experimental treatment is equal or superior to the established treatment."

There is, incidentally, a difference between y'all and all y'all, :-) Howard C. Berkowitz 16:25, 17 December 2008 (UTC)

Ramanand, I'm not suggesting you do anything, however, if you are not satisfied with an editor's decision, this is one place where it is discussed. D. Matt Innis 18:36, 17 December 2008 (UTC)

measures of efficacy

Joining the conversation rather late - I don't agree that this sort of issue should be deemed 'not open to discussion' - such language seems not merely regressively hierachical, not merely to stifle the free flow of ideas, but also to create scope for ill-thought-out and inappropriate views to be inserted in pages without the normal benefits of collective review and editing.

On the precise issue of homeopathy's benefits, it seems to me that there are legitimate benefits to treatments 'perceived' to work, even if 'in fact' they do not. That is to say, many 'conventional' medical treatments are counted as having a medicinal value even when statistical evidence shows them to not merely ineffective but actually associated with worse health outcomes! Healing Arts writers will know better than me the cases - but I might tentnatively point at heart disease in particular (whereconventionally tested and 'approved' drugs still result in worse health otucomes) and cancers.

A related example we might consider in passing, is the very plain example of broken wrists. These are treated in UK hospitals with 'rigid' repairs, surgery and pins included, but in China through manipulation of the wrists and tight bandages. Often homeopathic remedies will be added. The Western treatments have appallingly low success rates (in terms of return to normal use of the wrist) compared to the 'alternative'. Yet the language of this page in 'ruling out' any evidence of medicinal effect for homeopathy contributes to the perception that (say) someone who has broken their wrist will be better treated through surgical intervention in a UK hospital than through visiting a traditional Chinese doctor.

My suggestion would be that specific claims here and elsewhere for health benefits can be justifiied through appropriate 'scientific' trials, or through 'user satisfaction' and surveys of actual effects and results. Ramanand's contributions (which seem to have been edited out largely?) on this are IMO relevant and should be incorporated.

Secondly, conventional health treatments should be described and discussed in an equally sceptical way to their 'unconventional' ones. Any thoughts? Martin Cohen 14:17, 17 December 2008 (UTC)

Martin, as I was telling Ramanand, if you are not satisfied with an editor's decision, this is one place where it is discussed. D. Matt Innis 02:33, 18 December 2008 (UTC)

Thanks, Matt. It seems one thing to deal with an author on a particular matter and then say 'end of discussion' - but the matter itself, in particular when it is central to the page, needs must remain open to discussion - or (IMO) we do not have a collaborative system at all. Can we clarify this matter? I've had no response to these points, which is as though they ARE 'banned topics' - would someone say that is the policy - if it is!

I'd understand it better if the objection is simply that the issues ahve been 'done to death' already - but even then, new ideas need to be permitted and treated on their merits. Martin Cohen 13:06, 18 December 2008 (UTC)

Martin, this community is your community, which means that you have input. Citizendium's model is spelled out in the CZ:Neutrality Policy, CZ:The Editor Role, CZ:The Author Role, CZ:Professionalism (to name a few). The way I do my job is spelled out in CZ:Moderator Group Blocking Procedures. The model is designed to be maleable according to community input through the forums and the CZ:Editorial Council, and other projects are in their infancy (or in some case, prenatal) stages, such as the CZ:Editorial Appeals Committee and likely CZ:Judicial Committee. There is nothing wrong with Gareth making a decision from the outset, but I assure you that it has a history beginning with Archive1 and several reverts on the article page. We encourage editors to make these decisions to avoid the type of metadiscussions from occurring on these talk pages and keeping work from progressing. That is not to say that you are discouraged from talking about it; you just have to do it through other means (the link I gave you before). Please feel free to open those doors. If there is no workgroup there, by all means, please help us start one. (Also notice that Larry has already checked in - that was one of your choices in that link). D. Matt Innis 04:47, 19 December 2008 (UTC)

ps.[ note: this relates to the earlier, not the immediately preceding paragraphs - MC]

And it seems to me that certain statements are breaching this principle: "It should not be necessary for me to point out that the article can neither endorse nor roundly condemn homeopathy. The article does not take a stand; it presents both (or all) sides on all controversial issues it presents, and leaves it up to the reader to decide for himself. The article does not endorse a position"Martin Cohen 14:31, 17 December 2008 (UTC)

I'm not going to extend this discussion; I've made an editorial ruling here that implements my understanding of Citizendium neutrality policy. The article should nowhere make an editorial statement affirming the efficacy of homeopathy, nor should it make an editorial conclusion denying efficacy; it should report the views of homeopaths (that their treatments are effective) and report those of conventional science and medicine (that they are placenbo effects), with attribution and leave it to the reader.

If there is anything you think is in breach of this principle, be specific please.Gareth Leng 14:54, 17 December 2008 (UTC)

Well, how about this section:

The theory underlying homeopathy is not considered plausible by most scientists working in academic institutions in Europe and the U.S.A. ... The conventional view is that homeopathy, insofar as it has any effect at all, exploits the placebo effect - i.e. that the only benefits are those induced by the power of suggestion, by arousing hope, and by alleviating anxiety.

This seems exactly as it should be - the article is reporting the opinions of mainstream scientists and physicians and attributing the opinions to that group. If the article said "The theory underlying homeopathy is not plausible; homeopathy, insofar as it has any effect at all, exploits the placebo effect - i.e. the only benefits are those induced by the power of suggestion, by arousing hope, and by alleviating anxiety." then it would be expressing an editorial opinion and would be contrary to neutrality policy.Gareth Leng 16:14, 17 December 2008 (UTC)

The 'safety' section implies that homeopathic remedies are responsible for some half a million deaths a year too! Martin Cohen 15:57, 17 December 2008 (UTC)

That's nonsense, of course it doesn't; it says that the measles vaccination programme was followed by a massive fall in deaths; that's a fact, introduced to explain why conventional medicine considers anti-vaccination advice as irresponsible. Gareth Leng 16:21, 17 December 2008 (UTC)

Well, Gareth, your overt rejection of discussion of this important, indeed central issue, seems to me to be wrong. I'm not sure that editors should be able to block general discussion of key issues - perhaps this would benefit from some exploration more generally in the Forum. As a 'philosopher', perhaps I can hlp spot where language is prejudicial to the neutrality policy we I'm sure accept, and where it falls short.

Yes, Martin, this is not the place to discuss policies. D. Matt Innis 02:33, 18 December 2008 (UTC)

Secondly, if your policy here: 'nor should it make an editorial conclusion denying efficacy' allows statements like :"The theory underlying homeopathy is not considered plausible by most scientists working in academic institutions in Europe and the U.S.A. ... The conventional view is that homeopathy, insofar as it has any effect at all, exploits the placebo effect - i.e. that the only benefits are those induced by the power of suggestion, by arousing hope, and by alleviating anxiety. " then it is not one I have got the finer points of. I t seems to me to be inconsistent with the neutrality policy and I shall suggest an improvement here now. See what you think! But if you don't like the change, I think it would be useful, in a positive spirit, to then use this as a dscussion starter in the Forum to help us all understand how to implement the neutrality policy in practice. Martin Cohen 19:50, 17 December 2008 (UTC)

This text looks messy left on the page as a footnote, although I think it 'could' be justifed there. But better would be on a page discussing vaccination policy.

Measles]] is not a major killer in the western world, where most children are vaccinated at about two years old. However, in 1999 there were 875,000 deaths from measles worldwide, mostly in Africa. In 2001, a "Measles Initiative" was initiated involving the American Red Cross, UNICEF and the World Health Organization, By 2005 more than 360 million children had been vaccinated, and the death toll had dropped to 345,000.

Adult herpes zoster infection is a reactivation of childhood chickenpox, affects 1 in 3 adults, and can cause chronic, severe [[neuralgia|nerve pain ("postherpetic neuralgia"} in 10-18% of cases, and eye involvement in 10-25%. Chickenpox immunization prevents this; a herpes zoster vaccine is now recommended for all adults 60 years and older. Childhood immunization against chickenpox prevents herpes zoster.</ref> Martin Cohen 20:29, 17 December 2008 (UTC)

Martin--first, you say, "I'm not sure that editors should be able to block general discussion of key issues," thereby implying that Gareth had attempted to block discussion of key issues. It is obvious to me, at least, that he had not attempted to do so. Second, having worked with Gareth a fair bit over the last 18 months or however long it's been, I trust his judgment on neutrality issues very well. Third, this whole discussion suffers greatly from a lack of clarity about what, precisely, you are disagreeing with Gareth about. What text is problematic? Fourth and finally, if the entire exchange here concerns only whether the text beginning "The theory underlying homeopathy is not considered plausible" and ending "by alleviating anxiety" is neutral or not, then I am confused. You have not made it clear why you think this text is not neutral. I'm sure that Gareth and I would be very interested to know your reasons for thinking so, but I don't see that you have offered any reasons yet. For my part, I see nothing wrong whatsoever with the text. It (I assume) factually describes a situation and, I imagine, even homeopaths can agree with it, grudgingly, even if they don't like the situation factually described: that homeopathic theory is rejected by most mainstream physicians. It is also obviously important that we say this in the article, if it is true. Of course, we should also make it clear in the article--whether we do now or not, I won't comment on here--that the mere fact that mainstream physicians do reject homeopathic theory does not mean that the theory is wrong. Of course, anybody who blindly follows mainstream medicine will draw that conclusion, but that is their choice, not a conclusion we are forcing them to make.

Anyway, Martin, if you can clarify why, precisely, you think the text is not neutral, then we can make some better progress here. And please--let's have no more comparing of credentials about who has the right to declare what is or is not neutral; let's compare arguments instead. --Larry Sanger 03:54, 18 December 2008 (UTC)

You are quite right Larry that we need to make clear that science is fallible, and to be aware that even if the reader accords authority to the opinions of scientists, arguments must be judged on their own merits. I hope that the article is moving to (very concisely) encapsulate the reasons behind the views of scientists, not merely asserting those views; please take a look at the Overview section. Gareth Leng 12:06, 18 December 2008 (UTC)

Avogadros

Deleted the first use of this because it is repeated later, but mainly because the calculation given was I think wrong. Maybe someone can check mine - I think seawater contains about 35 g NaCl/litre, so the deleted footnote was incorrect.Gareth Leng 13:19, 16 December 2008 (UTC)

It depends which sea. :) Chris Day 15:40, 16 December 2008 (UTC)

I almost said that. It also depend, I suppose, if you make your molecular guacamole from Florida or California avogadros. Howard C. Berkowitz 15:47, 16 December 2008 (UTC)

California Avogadros, LOL, now that is funny, I don't care who you are :-D D. Matt Innis 16:09, 16 December 2008 (UTC)

Yes that is droll. Salinity of 3.5% by weight is sort of standard for sea water. I compute that one spoonful gives 1/3 molecule NaCl per liter water after dilution by a factor 10⁻²⁴. Same order of magnitude.--Paul Wormer 17:15, 16 December 2008 (UTC)

That's also the order of magnitude that Dana cites above in the not even a single molecule section. Chris Day 18:51, 16 December 2008 (UTC)

Avocado's number has a very high calorie content, I think. (Glad to see us go off the deep end at times). Dana Ullman 03:34, 17 December 2008 (UTC)

Avocado, Dana?—Ramanand Jhingade 07:36, 17 December 2008 (UTC)

Ramanand, hopefully this will be an enjoyable contribution. Avocados are a fruit that grow in semi-tropical areas of the United States; they may have another name or not grow in your region. Unusual among fruits, they are very high in fat content. California and Florida avocados look very different on the outside, although the inside is comparable. It was merely meant as a play on words. A low-calorie serving of avocado would have to use a good deal of dilution. Howard C. Berkowitz 14:59, 17 December 2008 (UTC)

Mithridates

Mithridates was King of Pontus, not a Roman emperor, so I've corrected that. However there appears to be some confusion in the classical sources as to whether he took poisons to habituate himself or whether he had a special antidote or theriac called "Mithridatum", supposed to have been rediscovered or improved by Galen. In any case I doubt that the story is much use as anything other than a metaphor. Richard Pinch 19:56, 16 December 2008 (UTC)

I just put in a footnote about the Housman poem. Also, I am gonna look up his actual name -- the VI in the middle seems weird to me. Hayford Peirce 21:00, 16 December 2008 (UTC)

Funnily enough Mithridates VI Eupator is his "actual name". Why would you assume it wasn't? Richard Pinch 21:15, 16 December 2008 (UTC)

Because I googled it and got very conflicting info; some hits call him that, others say he was *also* called that, others say a third thing altogether. I'm now turning the pages of my Webster's New Biographical Dictionary, let's see what they call him. "Mithridates VI Eupator. Called the Great". Hmmm. That's pretty authoritative. Let's see, what my 1940 EB calls him. They call him "Mithradates VI. Eupator, called the Great". With an "a" in his name (they say that the "i" is commonly used but is incorrect). And, for some reason, a period after the VI. That's good enough for me -- I'll change it back. Hayford Peirce 21:24, 16 December 2008 (UTC)

Over-the-counter

Gareth, do you have a total OTC sales figure for non-homeopathic medications, to put it in context?

£1.2 billion total OTC in 1994, haven't found anything more recentGareth Leng 18:14, 17 December 2008 (UTC)

Stray question: do you know the EU/EC or UK labeling requirements for OTC preparations? In the U.S., the normal FDA requirements are that all ingredients must be identified, on the package, with the standard nonpoprietary name. The box of Oscillococcinum, however, only identified the active ingredient in Latinate traditional homeopathic terminology. Is that a universal exception for homeopathic remedies? Howard C. Berkowitz 18:01, 17 December 2008 (UTC)

The homeopathy-placebo ruling; some practical advice

I don't think it's useful now to question Gareth's editorial ruling.

You see, I just added a research update to one of the 2 other homeopathy articles (Memory of water is one, Tests of the efficacy of homeopathy‎ is the other). These two articles address the core issues of the scientific plausibility of homeopathy theoretically and clinically, respectively (they were part of the homeopathy article initially).

For now, this Homeopathy page tells that there is a majority of conventional clinicians thinking that homeopathy is no better than a placebo, and pro-homeopaths who think the opposite. Those are facts, but presenting this as a useful way to deal with such a topic is biased.

The Journal of Clinical Epidemiology published a refutation of the famous 2005 Lancet (the meta-analysis claiming that homeopathy is at best a placebo). It used the same data and showed the opposite. The point is that you could have a number of competent epidemiologists agreeing that the Lancet study actually supported the superiority of homeopathy over placebo, it wouldn't change the "majority view vs minority view". We're dealing with mass behaviors; Martin would have a lot to say about this. So if neutrality in this Homeopathy article means presenting majority vs minority dichotomies, instead of going to the key issues:

• the controversy over the Lancet study,
• the replication of Benveniste's study (see above, Madeleine Ennis),
• The media debunking that followed (see Dana's correspondance with Ennis)
• The materials science of water at the *mesoscopic* scale and Martin Chaplin's respected work,
• the placebo-independent studies in plants, animals and cell cultures,
• The publication bias against homeopathy,

... those interested will just have to move on and work in the background, since it's been put there by editors. --Pierre-Alain Gouanvic 08:59, 18 December 2008 (UTC)

I've looked at the JCI paper; to call it a refutation is I think not true. Indeed the paper (from two homeopaths) confirmed that Shang's calculations were correct, they look at how the calculations are influenced by chosen cutoffs. What Shang et al showed was that the size of the reported effects of homeopathy diminished with the size and quality of the trials, so that if only the biggest and best trials were analysed there was no significant effect seen above placebo. What the JCI paper shows, (perhaps not surprisingly), is that this depends on the cutoff chosen; if, instead of counting just trials with more than 98 subjects (Shang's cutoff), trials with more than 66 are included, then there is an overall significant effect in favour of homepathy. The JCI authors say "This result can be interpreted differently. Following Shang's perspective it can be explained by small study bias (which includes publication bias). In contrast, one may hypothesize that Shang's result is falsely negative." In their conclusions they thus state "Our results do neither prove that homeopathic medicines are superior to placebo nor do they prove the opposite. " Perhaps the most interesting aspect of this paper is their analysis of variance in study outcomes. The outcomes were more variable than expected from a random distribution, so one possibility is that homeopathy is effective in some conditions not others. The JCI authors noted that four of the 21 best trials dealt with preventing or treating muscle soreness - these consistently found no benefits to homeopathy, so if it is accepted that homeopathy is not useful in this condition, the remaining 17 trials show an overall significant effect. However, the overall positive result "was mainly determined by the two trials on influenza-like diseases"

Generally, for any statistical analysis to be valid, it must be guided a priori by a clear hypothesis - in most simple terms, if you have a sample population with different heights, you can't take the tallest 10%, compare their heights with the shortest 10%, and conclude they are significantly different. This is fundamentally the difficulty with selecting the two influenza trials (the top 10%) and the four muscle soreness trials (the bottom 10%), you just can't do this and expect the statistical conclusions to be sensible. (I'm simplifying; the JCI paper was more subtle, and they didn't claim that they can draw such conclusions, but raised them as a possibility). Shang's hypothesis was that all homeopathy is placebo effect; it's a hypothesis that, like all scientific hypotheses, can never be proved, but only tested - exposed to attempted disproof. Their hypothesis survived attempted disproof; this is how science works. It's counter-intuitive for non-scientists - we work by trying to show that our ideas are wrong, not by trying to show they are right.

It was never the case that the Shang study proved homeopathy was all placebo - and nobody should state it in these terms - what it showed was that the results overall from the trials analysed were consistent with them being placebo effects. The JCI paper says that they are equally consistent with some treatments (muscle soreness) being ineffective and treatments for influenza being effective. This seems fair. Overall, the results of trials do not provide compelling evidence for the efficacy of homeopathy, but leave open the possibility that it is effective in some conditions and ineffective in others.

Dana, do any homeopathy sites advise practitioners against treating muscle soreness on the grounds that treatments are ineffective?Gareth Leng 13:38, 19 December 2008 (UTC)

Each of these issues is interesting, and appropriate to explore carefully but to do so in a way that is clear and accurate will just take a lot of space and a lot of time. Pragmatically, this article is never going to get approved if these issues are introduced here. Arguments about statistical analyses get highly technical and are often irresolvable objectively - and in the end the bottom line is clear, scientists do not consider the evidence for efficacy to be compelling. Attempted replication of Benveniste's study is covered elsewhere and is disputed, Martin Chaplin seems a sensible person and I'm sure deserves respect as we all do; but don't imply that he's well known or highly cited or influential; he's an academic in a minor teaching University and not as far as I'm aware research active - and as far as I am aware he's an agnostic rather than a believer in homeopathy (I agree that agnosticism is rare among scientists). The memory of water explanation lapses on the key issues of a) how the structure in water could be detected (and how a mechanism for detection could have evolved) b) how a detection mechanism can be specific for the type of memory and then linked to a specific adaptive response and c) how the structure is preserved in pills without water. Thus the memory of water notions do not explain homeopathy, but at best would provide a possible small starting point. Placebo-independent studies - well there has to be some reality check here; there are several thousand journals in PubMed alone and this excludes many many shoddier journals. Now even in the best journals, many papers just get it wrong and virtually all studies (of everything) are flawed in some key way. Scientists do not take any study at face value - because they know of so many ways in which people can just get it wrong. They do read papers look for flaws and filter - the results of the filtering you can see for example by looking at citation data - is the paper regarded as sound and important - is it cited, who is it cited by, how is it cited - and what is it cited for? You can easily these days find every paper that has cited any published paper. We cannot here write a commentary on every published paper and its weaknesses but have to filter by impact and notability in some way. If there is enough reason to interrogate these studies then OK, but it will be a harsh blitz I'm afraid - but maybe needed. On publication bias - careful about the wording because publication bias technically refers to bias in favour of reporting study outcomes when they are significant and not when the outcome is not significant - this is a bias that favours reporting of positive outcomes. Bias against publishing papers from homeopaths - well its questionable whether it exists; hard to separate this objectively from judgements about scientific quality of the study.Gareth Leng 09:46, 18 December 2008 (UTC)

I agree, Pierre-Alain, those are all good and worthy topics. I hope that you can make some headway here. I hope that you will begin to take a stab to a NPOV review of each item. I think that it is not hard to summarize the recent Journal of Clinical Epidemiology review of research in a non-technical way. As for memory of water issues, I'm glad that Gareth acknowledges that Martin Chaplin is a good objective source who is not an "advocate." His website is reference-laden, and although he doesn't seem to conduct research himself, he provides the blessed service of reviewing objectively the research of others. The challenge is to keep it simple (non-technical) and non-detailed, with links to the best references. Dana Ullman 03:48, 19 December 2008 (UTC)

The major problem with this topic from my perspective is that once you open this door the whole article gets swamped with the discussions of mechanisms of homeopathy. And given that much of this work does not generalize very well, and is contested, it detracts for where the focus of the article should be. As a reader i want the big picture perspective of homeopathy. Bring in too many details and the article is less enjoyable and IMO, less informative. Chris Day 03:59, 19 December 2008 (UTC)

Following up on Chris' comment here, I think it is key and feasible not to limit the number of appropriately linked articles, so, for example, one gives the big picture of homeopathy. The possible mechanisms of homeopathy is a different topic at a different level of detail. Certain articles, as in many technical fields, may have to have (preferably stated) assumptions about the reader's background.

There are the questions about publication and acceptance bias. There are questions, to which Gareth gave me an interesting U.K. government report link, about how to assess things that simply don't lend themselves to classical clinical trials.

I have started on an article, integrative medicine, for which I have a fairly specific focus in mind, and I would hope people can collaborate in that focus. The article is intended to look at the current practice of interdisciplinary groups that consciously mix conventional and complementary disciplines, and, for that matter, exclude certain conventional and alternative methods. The article is focused on current practice, and I really would hope to avoid arguments about "well, why don't they include discipline XXX" — because I think it is useful to see how working interdisciplinary teams, trying for best patient health, use different disciplines. Incidentally, has anyone else noticed there is no article on nursing, one of the most integrative approaches around (at the leading edge)? Howard C. Berkowitz 04:49, 19 December 2008 (UTC)

Martin's changes

The Measles section I'm perfectly happy to see in a footnote; it's important to include because the issue of vaccination misadvice is probably the single biggest reason for deep antagonism to hemeopathy, but is tangential.

On the minor change that I reverted - here it's simple, the article is declaring the consensus view, not a suggestion. Is it the consensus scientific view? - well here we differ from Wikipedia because we have experts who should know what the consensus view is and I am one and other Health Sciences editors will correct me if I am wrong in this.Gareth Leng 09:21, 18 December 2008 (UTC)

Good! I think the article conveys better now what I am sure was the original intention.Martin Cohen 11:18, 18 December 2008 (UTC)

Re.Larry's question above and the role of Paracelsus - this question reflects the view one takes of homeopathy - that is to say, if one looks at it from a cultural and historical perspective or from a 'scientific' perspective as a medical 'method'. To some extent then, yes there is more to be said about Paracelsus's role in medicine, but given the page's overall character, perhaps not here. In a few words - yes, one sentence will do! Martin Cohen 13:29, 18 December 2008 (UTC)

Re. Matt and Larry and 'stifling debate' - I am not intending to reduce thhis to a personal matter - as far as I'm concerned Gareth , Howard, Dana and I are all 'trying' to reach the same ends... Apologies if I have implied otherwise!

Re. Matt, above. Thanks, Matt. My idea was that it seems one thing to deal with an author on a particular matter and then say 'end of discussion' - but the matter itself, in particular when it is central to the page, needs must remain open to discussion - or (IMO) we do not have a collaborative system at all. Can we clarify this matter? I've had no response to these points, which is as though they ARE 'banned topics' - would someone say that is the policy - if it is!

I'd understand it better if the objection is simply that the issues have been 'done to death' already - but even then, 'surely' new ideas need to be permitted and treated on their merits. Martin Cohen 13:29, 18 December 2008 (UTC)

Martin, perhaps I can put this into some perspective. If you wanted to pursue a debate about a "cultural and historical perspective" on homeopathy, as you say, then given that the others here evidently don't share your understanding about this, I think you ought to try to explain your thoughts in more depth. Right now, as far as I can tell, you've just made a bare, and to me quite vague, assertion about a "cultural and historical" character of homeopathy, and complained that this is not well represented in the article. I'm sorry, but by itself, this unadorned complaint is shrugworthy, and that is no doubt why nobody has responded much to it. To rectify the situation, you might write several paragraphs that explain this broader view, and which might or might not be included in the article. Then, you might offer some sources, credible to those who know about homeopathy, that explicitly or at least clearly endorse this broader view. (Just as a data point, it obviously was not at all clear that the sources you offered above supported the notion that Paracelsus was the father of homeopathy per se. As far as I can tell, you might say he was a precursor of homeopathy in about the same way that Locke was as precursor of the political thinking of the founders of the United States. But you'll find many people disputing that Locke was literally a founder of the U.S.A.) Just try to understand the situation, please. When you, a philosopher like me, come to this venue where there are two practicing homeopaths (one of them a leading published authority on homeopathy from a homeopath's persective), a professor of physiology who knows a lot about homeopathy, a chiropractor who is also a healing arts editor, and someone who just happens to know a fair bit about medicine--and others!--have all been working for months on an article, and you start complaining that the article lacks certain legitimate perspectives, the burden is decidedly on you to explain the allegedly missing perspectives clearly and to provide adequate evidence of them. The burden really cannot be on others to guess at what you might mean, and to judge claims that are plainly not obvious to them (the experts, after all!) without any evidence. The point here is that nobody is attempting to silence you or stifle debate. If there has been a disappointing lack of response, my guess is that it is because the others feel they have not been given enough to respond to.

Also, to everyone: please sign all of your comments! It's very annoying to have to figure out who wrote what. --Larry Sanger 15:28, 18 December 2008 (UTC)

Larry, I see that some people here are deleting names/signatures - I hope you can warn/ban them.

Martin, I got this quote from the Encyclopedia Brittanica at, 'http://www.britannica.com/EBchecked/topic/270182/homeopathy':-

practiced by Paracelsus ( in Paracelsus: Assessment. ) ...for sin administered by mountain spirits. He was the first to declare that, if given in small doses, “what makes a man ill also cures him,” an anticipation of the modern practice of homeopathy. Paracelsus is said to have cured many persons in the plague-stricken town of Stertzing in the summer of 1534 by administering orally a pill made of bread containing a minute amount of the [pateient's excreta]...

I'm sure you can condense & insert it because it's a reliable source (of course you should mention that web-site as a reference).—Ramanand Jhingade 08:29, 19 December 2008 (UTC)

No problem I've added this - but on checking it seems this report comes from Paracelsus' own account, so I have ammended the wording.Gareth Leng 16:19, 19 December 2008 (UTC)

Excuuuuse me, friends, but using "excreta" is not the homeopathic principle of similars! Although Edward Bach (the bacteriologist who experimented with homeopathy and who later developed the Bach flower remedies) used bacteria from stools and potentized them, this is a minor and little known series of homeopathic medicines. It is not notable, and the sentence that Gareth crafted has no place here. Dana Ullman 17:46, 20 December 2008 (UTC)

Back to Paracelsus! Response to Larry's questions

Thanks Ramanand - another well-chosen suggestion in my view - but look Larry, and Gareth and Howard - you've made heavy weather of the Paracelus contribution so far, so I'd ask someone else to add this sort of information in.

And yes, it is hard to 'navigate' on this talk page, I made that point earlier, but it's clearly 'more than my life's worth' to archive it myself...!

To respond to Larry above - and my edit adding Paracelus - well, what was the problem with it? Larry, contributors to CZ do not need to make lengthy 'pre-edit' arrangements do they? My contribution was barely a line long based on the odd failure to mention Paracelus in the article. I expected this to have been corrected without complaint or controversy - yet it has led to endless wrangling! `None too friendly either..

As mentioned above, I suspect the problem is that the article is attempting to impose a narrowly Western interpretation of the science of the subject. That's not an accusation against the other editors/ authors, it is a 'suggestion' that despite the best intentions, things have gone amiss here and there. Not necessarily big issues either. I think the 'roots' of homeopathy have been downplayed, and the disputes about scientific testing overstressed. Larry, you say this sort of feedback is 'shrugworthy' and I should write a small essay on it instead! Well, I think we have two kinds of feedfback. One is a sentence long and may or amy not be right. The other is an essay and is equally debatable and takes everyone too long both to read and write. Summation is not a bad thing. If people are open-minded, they will consider my point. They don't need an essay with it.

But I'm not asking to determine the nature of the page, only to be able to make suggestions - usually as edits to the page proper, for that is what a collaborative encylopedia is about - and offer feedback. I'm sorry to 'apparently' find myself and see other contributors being 'warned off' for doing the same - or do I misread things?

Larry, the fact' is that Paracelus is a noteworthy figure in the history of homeopathy. Even as I was being told flatly on the Talk page that he was 'NOT to be mentioned again", one of the Health editors was reinserting a reference. Nonetheless, the initial editing judgement was made to delete my original contribution in its entirety, rather than modify it. This, I think was wrong, and reflects something also wrong with the way CZ is operating. I suggest instead that when a contribution is made which is 'controversial' in one respect, that aspect is modified, and the rest of it, assuming that it is 'uncontroversial', is accepted. In the case of my edit, I reinstated the text modifying it to remove the 'controversial' claim (I'd say it is ambiguous, rather) that he is the 'Father' of Homeopathy to say this:

Paracelsus (1493-1541) is regarded by many as the 'founder' of homeopathy, and is also credited with popularising the theory "of signatures". According to this, the medicinal use of plants is revealed in exterior signs such as colours or shapes.

Note that I changed the word 'Father' to 'Founder' and I inserted the word 'many'. I'm not saying that this edit was brilliant, the final word, etc etc, but I am saying that I modifed my modest contribution in response to the criticism of the first version. 'Founder' may have been WORSE than 'Father' in fact, but it was an attempt to deal with the objection. I additionally added some examples to the Talk page (see Ramanand above too!) of people according Paracelsus a significant role. The Theory of Signature is discussed on the page (in the form of the related 'Law of Similars') - again without reference to Paracelus. The text I thought went some way to correcting that too. I acted in a positive spirit of co-operation throughout and I can't see the encylopedia benefitting from the precedent advanced here - even now by Larry? - where contributors have to justify their material 'off the page' rather than make them directly.

By editing the page directly, what has been the outcome? A good 'compromise'has emerged, I think, in that Paracelus is allowed a role in the development of homeopathy, albeit a minor one, and the link between the theory of signatures and hoemeopathy is indicated, which others can expand on through a new page I am sure if they wished. In other wrods, the page has benefitted and improved from the process of collaborative editing of the page proper.

So far, the message here however is against direct editing of pages. Can I have some reasurance that that is not the intention? Martin Cohen 13:57, 19 December 2008 (UTC)

Martin, I didn't say there was anything wrong with your edit adding Paracelsus. I don't claim to know anything about Paracelsus or have an opinion about the merits of anything you're saying about homeopathy. I was responding to your own complaint that there a "cultural and historical perspective" on homeopathy is lacking. I thought you were saying that this perspective would be added satisfactorily (to you) only if the article were rewritten or added to somehow, with far more than just the Paracelsus sentence. Or, as you now put it, the article suffers from a "narrowly Western interpretation of the science of the subject." (I don't know what Paracelsus has to do with the non-Western perspectives, frankly.) You responded to me by saying, "Larry, you say this sort of feedback is 'shrugworthy' and I should write a small essay on it instead!" Sorry, but you are incorrect. I did not say that this sort of feedback is "shrugworthy," but that a particular "unadorned complaint" was shrugworthy. Which, I reiterate, it was. Sorry, but it's true.

My point, which should not be at all controversial or even insulting, is that if you were to elaborate your complaint, so that people knew what you were talking about, then they might not shrug it off! If you think that there is a problem about a "narrow Western interpretation" of homeopathy here, I'm afraid the burden is on you to give some of the information about the non-Western perspectives that are missing. Since we are all volunteers here, with minds of our own, we cannot demand others to include some perspective they're not familiar with, or even agree to it if they are; but we do have the right to engage them in a dialogue, of course. (And here, your collaborators may have been in the wrong in one or two instances.) You say, "If people are open-minded, they will consider my point. They don't need an essay with it." But I'm not seeing evidence that they understand your point about non-Western perspectives, at least, in the first place. You have to elaborate that point at least some more, it appears, if you want them to consider it. Isn't that, well, kind of obvious? And if all you want to do is to make a suggestion and offer feedback, and not persuade others, then apparently you've done that to your own satisfaction--right? But your behavior here indicates that you don't just want to make suggestions and offer feedback, but that instead you want to persuade others.

You say: "I'm sorry to 'apparently' find myself and see other contributors being 'warned off' for doing the same - or do I misread things?" If anybody warned you off, the comment should have been deleted by the Constabulary with {{nocomplaints}}. Show me where the warnings-off are, and I will delete them myself. In any case, consider yourself officially welcomed by the Editor-in-Chief. And you also say that someone told you that Paracelsus was "NOT to be mentioned again"--I can't find that exact quote on this page or in /Archive 8, so this apparently was not an exact quote, or it was (properly) deleted by the Constabulary. As Editor-in-Chief, I hereby declare that you have the right to discuss Paracelsus on this talk page. It is pointless to complain about this sort of thing. Just know that anybody who presumes to warn you off, or instruct you that a certain subject cannot be discussed, probably doesn't know what he is talking about.

You also say: "Larry, the fact' is that Paracelus is a noteworthy figure in the history of homeopathy." Wait a moment--Paracelsus was a Western figure and perspectives on him are presumably not non-Western perspectives. Do you have two separate concerns, then, one about Paracelsus and one about the dearth of some (as yet undescribed) non-Western perspectives?

You say again: "Nonetheless, the initial editing judgement was made to delete my original contribution in its entirety, rather than modify it. This, I think was wrong, and reflects something also wrong with the way CZ is operating." That's your opinion; I disagree. If its removal was discussed, it was within the boundaries of acceptable practice on CZ. Do we really need to keep talking about this?

You also say: "I suggest instead that when a contribution is made which is 'controversial' in one respect, that aspect is modified, and the rest of it, assuming that it is 'uncontroversial', is accepted." That sounds reasonable. I would hope that that is what we already do in most cases. If we didn't do that in this particular case, probably somebody did make a very minor mistake--not a major mistake that merits going on and on about.

You say:

In the case of my edit, I reinstated the text modifying it to remove the 'controversial' claim (I'd say it is ambiguous, rather) that he is the 'Father' of Homeopathy to say this:

Paracelsus (1493-1541) is regarded by many as the 'founder' of homeopathy, and is also credited with popularising the theory "of signatures". According to this, the medicinal use of plants is revealed in exterior signs such as colours or shapes.

Note that I changed the word 'Father' to 'Founder' and I inserted the word 'many'. I'm not saying that this edit was brilliant, the final word, etc etc, but I am saying that I modifed my modest contribution in response to the criticism of the first version. 'Founder' may have been WORSE than 'Father' in fact, but it was an attempt to deal with the objection.

This looks fine to me as described. You've just described what happens in the rough-and-tumble of collaborative editing. The text as it is now is, I hope, fine with everybody.

A bit more from you: "...and I can't see the encylopedia benefitting from the precedent advanced here - even now by Larry? - where contributors have to justify their material 'off the page' rather than make them directly." That's incorrect as a generalization. Sometimes contributors do have to justify additions on the talk page first, but very rarely and only for good reasons, I would say. On the one hand, you were in the right to make the addition to the page that you made, as you saw fit. On the other hand, others were in the right to remove your addition and then ask you to discuss it and give more evidence.

"So far, the message here however is against direct editing of pages. Can I have some reasurance that that is not the intention?" Of course, but I think it was hasty to draw the conclusion or suggest otherwise in the first place.

Anyone who suggests that articles may not be edited directly and vigorously, and that all or even most editing must be done only after lengthy discussion, is just wrong. But then, I don't think that anybody was suggesting that here, frankly. I do agree with you, Martin, that some people might have been wrong in their attempts to "shoo you away." Shame on them. But is it really necessary to complain or discuss any more about this?

Can we stop the meta-discussion now, and turn to elaborating those unelaborated non-Western perspectives? For my part I'm pretty sure this is all I'm going to be able to contribute to this page, unless something very dramatic happens... *groan* --Larry Sanger 17:34, 19 December 2008 (UTC)

Larry, thanks for going through all this, and I think, quite honestly, it's more about not knowing other people's style and methods than any great issue, worthy of so much attention! I'm reassured about the spirit of CZ and any further referencing/ explanation of the points above will just waste your time, so I won't offer any. As far as I'm concerned, the debate over this page has been rather fraught but nonetheless productive. But most of all, I agree, it's a good idea to bring it to a close! Martin Cohen 19:43, 19 December 2008 (UTC)

Hi Martin, as for archiving, you might have missed it when you went out of town, but Hayford did archive just after you asked for it [2]. You are allowed to do this as well anytime you like. D. Matt Innis 05:17, 20 December 2008 (UTC)

I was going to archive again, but some of the discussions are just coming to conclusions and I want to make sure everyone has the opportunity to follow-up. D. Matt Innis 06:17, 20 December 2008 (UTC)

Martin, Hahnemann has quoted Hippocrates supporting the idea of 'likes cure likes' (in the 6th edition of Organon), but no one here is going to accept either Paracelsus or Hippocrates as the Fathers/Founders of homeopathy.—Ramanand Jhingade 12:07, 20 December 2008 (UTC)

Some people here may be knowledgeable about Paracelsus, but in due respect, I wonder how much people who have been adding info about him here understand about homeopathy and what the "principle of similars" means (please note that I am just wondering; I am not saying something emphatic here). My new concern is the statement in the article, "This led him, for example, to teach that the pricking of thistles cures internal inflammation, and is sometimes cited as an early form of the 'principle of similars'." Unless someone explains to me the "thistles cures internal inflammation" is an early form of "similars," I will delete this unclear reference. At best, this is a crude and non-specific reference. Did Paracelsus assert that thistles cure all internal inflammation? This is a overly simplistic assertion and has no place in THIS article. I will withhold deleting it right now, but it is likely that I will do so shortly.

I understand that one of Paracelsus' real contributions to healing was that he was one of the first (perhaps the first) to use minerals as a medicine (previously, herbs/plants and animal were the primary medicines). That said, this info has little place in this article and has a place on an article about Paracelsus. Dana Ullman 18:05, 20 December 2008 (UTC)

Martin, after those two comments from Ramanand and Dana, our resident homeopaths, the burden is now clearly on you to show that there are homeopaths who regard Paracelsus as a father or founder of homeopathy. Again, nobody is preventing you from offering this evidence. Indeed, I'm specifically asking for it, and Dana is specifically asking for evidence/clarification on another point. The mere fact that Paracelsus is mentioned in homeopathy texts does not come close to clinching the point. --Larry Sanger 18:10, 20 December 2008 (UTC)

Final Arguments in the Case of Paracelus

I 'think' that is an invitation to use the P-word again, having also been asked to not stir things up needlessly! So, with all efforts to be avoid stepping on expert toes, here is the point about Paracelus summed up:

1. The central principle - as stated in the meta notes for this page - is

"Alternative medicine that uses extremely small specially prepared doses of the drugs that cause the similar syndrome of symptoms as the person's illness."

This is the idea that prompted P to connect 'thistle scratches' with inflammation, and 'miniscule parts of plague excreata' with curing the illness itself. As noted already, the quote are in the historical origins section and illustrate the central homeopathic idea of 'like cures like'. It may not be 'homeopathic' in the current sense, but it has historical notability.

2. Paracelsus popularised this idea, influencing Hahnemann. Pierre-Alain provided a quote confirming that:

"Peter Morell (historian of medicine, with training in homeopathy and conventional biology), "Hahnemann and Homoeopathy". ... Hahnemann was reluctant to associate his new system of medicine with the name of Theophrastus or Paracelsus for fear of being misunderstood or being accused of plagiarism. (p. 15)... The truth is of course, that Hahnemann was a second Paracelsus, but he felt he had to hide this fact. (p.72)"

3. I do not especially wish to argue for P as either the 'Father' of Homeopathy - or as a 'founding figure'. In response to Dana's request, I gave examples showing that 'some' people say he is the former, and others consider him the latter.

I also offered: ""The doctrine of signatures was a purely philosophical notion until Boehme's predecessor, the alchemist Paracelsus, had applied it to medicine ..." from page 27 of The American Institute of Homeopathy Handbook by Edward, M.D., D.Ht. Shalts"

As Pierre-Alain put it:

"My conclusion is that the influence of Paracelsus on Hahnemann, a very erudite person, was major. There are far more resemblances between P and H than this (signatures). Should we say "father of homeopathy"? perhaps, with a cautionary note."

It is enough, in my view, to recognise he had a 'noteworthy' influence. Ramanand has provided several good points in this regard,such as that the Brittannica article on Homeopathy states that P "was the first to declare that, if given in small doses, “what makes a man ill also cures him,” an anticipation of the modern practice of homeopathy. "

Martin Cohen 18:43, 21 December 2008 (UTC)

Martin, please take this as a constructive suggestion. To quote one of your earlier comments, "problem is that the article is attempting to impose a narrowly Western interpretation of the science of the subject", that observation reminds me of a classic comment in the computer industry, "that's not a bug. It's a feature."

So, I would agree that the article is attempting to impose a narrowly Western interpretation of the contemporary Western interpretation of the term homeopathy. I see that as a good thing. In no way does that preclude having a separate article(s) on common historical features of signatures, similars, and other ideas, including Frazier's anthropological statement of the Law of Similars.

Speaking from a computer and information science background, the fundamental idea of hyperdocuments (a superset of the World Wide Web, which is a superset of wikis, which is a superset of CZ) is that the reader can link to whatever level of background and detail as the reader desires. The full background and detail need not be replicated in each wikilinked article. As a technical book author, one of the challenges is how much detail I need to give in background, before referring to a reference the physical book reader may not have. That is not a restriction in hyperdocuments.

I believe it is fair to say that a reader using a wiki will usually want, as a first approximation, the most widely used current meaning of a term. Depending on the subject, there may well be some summary of history and philosophy, but the details do not need to be in the article. No one seems to be arguing that Hahnemann neither create the term homeopathy nor establish its basic western expression, which I see as the main focus of this article. Paracelsus and Hippocrates and others may or may not have been formative influences on Hahnemann, but this is simply not an argument over an original discovery. If you want to see such an argument, look at human immunodeficiency virus and the roles of Luc Montagnier and Robert Gallo. That is the sort of thing where intense debate is appropriate: two contemporaries where there is debate about whether there were independent or derivative discoveries. Paracelsus and Hahnemann were not contemporaries. Howard C. Berkowitz 19:08, 21 December 2008 (UTC)

Apropos signatures, homeopathic parallels, etc.

Hopefully to avoid some conflicts, I'm working on some other articles that may be of interest. Some may appear to overlap, and some are defined in a way that they really do not.

First, let me mention something I wrote after discovering something from a U.K. link that Gareth sent me: Bach flower therapy. Bach makes clear that he is not talking about homeopathy, but does credit the British Homeopathic Pharmacopeia for the method he uses to create his "mother essence" or "mother tincture". He makes it clear, however, that he is not using the Law of Similars, and that he doesn't ultradilute. Why I thought it interesting, however, is that while he does not explicitly credit Paracelsus, he specifically uses the term "signatures" and also speaks of shapes, colors, etc. It might provide an interesting compare-and-contrast.

Another new article, which I'm still editing and creating -- there will be tables that are being rearranged -- is integrative medicine. This is a relatively new paradigm that I've sourced to a number of highly regarded medical institutions (e.g., Mayo Clinic, Johns Hopkins, Duke, Columbia) where they have a joint center where biomedically trained physicians and selected alternative practitioners collaborate. In that article, I am specifically trying to cover which medical and complementary techniques are being used together now, and how the groups address such things as interactions, different paradigms, and possible interactions. I would appeal not to add arguments that "X,Y or Z" should be added, because I'm trying to describe current practices and their arguments for the choices they have made. Truly "alternative" systems that want their models used exclusively simply are not part of integrative medicine, but, hypothetically, if a patient had a chronic pain syndrome, the patient might, simultaneously have analgesics or muscle relaxants prescribed by a rheumatologist, a homeopathic remedy that the homeopath and physician agree is compatible, acupuncture, massage with essential oils prepared by an aromatherapist, etc. All these practitioners have agreed, in their model, that the combination could be safe and effective, although it will be closely monitored. I am going to be discussing the paradigm these practices use, and I'd appreciate not trying to superimpose other paradigms or disciplines they "should" use.

One striking contrast is that they have a great deal of nursing involvement, which, by and large, is not discussed anywhere on CZ. Columbia's center, indeed, is part of their School of Nursing. There is a strong movement in the nursing profession toward wellness and chronic disease management, with their focus not being on "cure". Howard C. Berkowitz 16:38, 19 December 2008 (UTC)

The Constabulary has removed a conversation here that either in whole or in part did not meet Citizendium's Professionalism policy. Feel free to remove this template and take up the conversation with a fresh start.

I'm not sure of the problem here, but the only reason I mentioned this is to let people know of a related article being developed, integrative medicine. Gareth gave me a U.K. government report on CAM, and I have been creating brief articles for all the CAM disciplines that the report lists. Bach flower therapy, of which I freely admit I had never heard, was one of them. I summarized information from the Bach site into an article, then did some quick literature searches, and didn't plan to do anything else.

Since the Bach page does specifically speak of following British Homeopathic Pharmacopeia methods to produce mother tinctures, but then explicitly uses them in a non-homeopathic way, it struck me that homeopaths might be interested in the article. I have no particular views on the subject. Howard C. Berkowitz 18:34, 20 December 2008 (UTC)

Done for now

My concern has been to get this article in a swift state for approval so that we can all relax and get on with other less heated things - including the many related articles that should appear and which should be less problematical. As I see things, this article is "about there" - I've inserted an example proving - I've done my best with what I could find, I chose bamboo jusy because I could find two commentaries on the proving, both of which declared it as exemplary. I've tried to stay close to the words of the reviewers. But the example may not be representative, I wouldn't know. I've trimmed and revised the testing section, including at the end what I think is a clear statement of homeopathic objections. I've added an Overview section, mainly from a scientists's perspective (I can't really help that) but acknowledging the fallibility of science. I've also extended the bibliography and external links. I've added references and detail as I found them for things that I thought needed checking, and the process of checking has led to occasional revisions. I would prefer it if the article had at least one or two illustrations, but I am not competent in that sphere.

I've tried to nudge the prose to be clear and direct natural language rather than technical language or jargon. Basically I've followed the rule "if it's not obvious to me what something is saying then it must be changed". So, I'll stand back now, and watch.Gareth Leng 22:53, 19 December 2008 (UTC)

Great job

It's in far, far better shape. There are a few places where edits may have lost some transitional words, and I will provide those soon. Just to avoid edit conflicts, I'm not going to make even the typographical edits.

Section: Homeopathic manufacture of remedies

• may I suggest that (preferably) the very visually impactful but incomplete table of four representative remedies be removed, and perhaps replaced with a link to appropriate online references? I assume, but am not certain, that would be a materia medica, and I have seen several links.
• The 3,000 remedies seems to have gotten separated from the text in the 5th (last) paragraph of Conflict with conventional medicine. See below.

Section: Similia similibus curentur : the law of similars

• typo: should be analogous
• Given that there's only a small amount of text before the subhead, I do think "Homeopaths consider that two conventional concepts, vaccination, and hormesis, can be considered as analagous to homeopathy's law of similars and the use of small doses." needs a note that these analogies, for technical reasons mentioned below, are not accepted by mainstream sciences.

Section: A typical homeopathic visit

There were, I thought, some references that indicated patients of homeopaths were especially satisfied with the quality of the interaction, and this should be noted. Now that the times of the initial and subsequent visits have been noted, I wonder if it might be observed that many conventional physicians, if they are freed from economic pressures, prefer those ranges as well. Recognizing that anecdote is not the singular of data, my personal experience is that the physicians I've found do best often do a 45-120 minute first visit and 5-20 for followups, the latter when no procedures are involved.

Section: Conflict with conventional medicine

• 5th (last) paragraph: the numbers of conventional drugs here were originally a compare-and-contrast made with 3,000 remedies, and were making a point that conventional physicians do individualize and have a wide range of methods, especially when polypharmacy is considered, to do so. This should either move up to Manufacture of homeopathic remedies or the 3,000 remedies should move here, but I did see them as an appropriate description of the compare-and-contrast.
• Gareth, there is good discussions on alternatives to the classic randomized controlled trials in the Parliamentary report link you gave me, <ref name=UKselect-summary>{{citation | url = http://www.parliament.the-stationery-office.co.uk/pa/ld199900/ldselect/ldsctech/123/12315.htm | author = Select Committee appointed to consider Science and Technology, U.K. Parliament | contribution = Chapter 7: Research and Development | title = Science and Technology, Sixth Report, Complementary and Alternative Medicine | date = 21 November 2000 }}</ref> That might be very good to work in here.

General

Without looking at the metadata, I thought the original language variant was AE, but, not surprisingly with Gareth's work, it's now tending more toward BE. When any more substantive changes are made, may I suggest that we decide on one or the other, and do an appropriate copy edit? Howard C. Berkowitz 23:40, 19 December 2008 (UTC)

The language is American English. This is not something we have ever changed in an article just because somebody made a lot of edits without consideration of the language variant we're using. --Larry Sanger 05:54, 20 December 2008 (UTC)

Fine. Just didn't know which direction to copy edit. Thanks. Howard C. Berkowitz 06:07, 20 December 2008 (UTC)

Shouldn't that be "Juss dang know wutt direction ter copy edit?"Gareth Leng 09:03, 20 December 2008 (UTC)- Please Howard, go ahead and fix whatever seems appropriate (including the points above)Gareth Leng 14:37, 20 December 2008 (UTC)

I don't mind making the changes, but I would ask for some assistance. My thought is that it would be better to replace a remedy table with a link to an online homeopathic source; I see several materia medicas online but I would like an expert recommendation on which to use.

Apropos the sections under "Homeopaths consider that two conventional concepts, vaccination, and hormesis, can be considered as analagous to homeopathy's law of similars and the use of small doses.", my preferences would be to delete the details completely. The sections on vaccination and mithridization are more argumentative than neutral, I think. Do you think they should stay?

The other changes seem straightforward enough. Since the visit lengths were stated in ranges, I don't see a conflict between homeopathy and what is considered good practice of medicine. When a conventional physician always sees everyone for six minutes, that's usually an economic or business issue; few physicians would recommend it. Since homeopathy, in many countries, does not have third-party reimbursement, the patient and clinician are more likely to agree on adequate visit length, than a physician employee working under a capitation model of reimbursement. Howard C. Berkowitz 15:51, 20 December 2008 (UTC)

content cleanup edit

This sentence was purposely edited to include the word kingdoms. I'm not sure that it is accurate to call minerals a part of a kingdom, but it looks like a content decision rather than copyedit, so I just brought it here.

• Other remedies are derived from the mineral and animal kingdoms.

D. Matt Innis 06:43, 20 December 2008 (UTC)

Wasn't Elvis the King of Rock? (yes, I had wondered about that as well) Howard C. Berkowitz 06:45, 20 December 2008 (UTC)

I inserted the word Kingdom to show that it is not the whole animal that's used in some Homeopathic remedies made from animal products (it used to read......made from animals).—Ramanand Jhingade 12:38, 20 December 2008 (UTC)

Yes, there is a mineral kingdom, and the word "kingdom" is a good one. Dana Ullman 18:13, 20 December 2008 (UTC)

Who uses "mineral kingdom"? I have not heard of this usage and have always found the "mineral and animal kingdoms" section a bit confusing. Chris Day 18:18, 20 December 2008 (UTC)

OK, I did a google and found the term used in quite a few general articles (one example). So it should be fine. Chris Day 18:30, 20 December 2008 (UTC)

Oh, good, glad I asked! I guess I could have done a google search, huh. My bad. D. Matt Innis 01:09, 21 December 2008 (UTC)

Pending issues?

I think the page is a lot better than it was even two weeks ago, but not ready by any means. Here are some suggestions.

The section 'historical origins' is inadequate - we only recently added in Paraceluss (sorry, yes him again) but there are other pre-Hahnemann figures and cases to note, particularly as we discuss the theories of similars and signatures on the page. Perhaps there should be a paragraph or two on the alchemical and chemical debates/ discoveries leading up to Hahnemann>

I'm not convinced of the value of adding more history here - but we need Dana's view on that. I think that in an article on "Medicine", material on the history of medicine prior to the mid 20th century would tell us very little about medicine today, and I suspect that something of that is true here - homeopathy today, throughout the world, dericves from Mahnemann and his disciples. Dana?Gareth Leng 17:20, 20 December 2008 (UTC)

Secondly, the 'philosophical' issue of the 'dilution' and 'potencies' of homeopathic remedies is not explicit - there is a debate over this that needs to be brought out.

Thirdly, the issue of how 'mainstream' homeopathy is in some countries has been left a little unresolved. We seem to have settled for a US-European perspective. Garth notes on teh CAM talk page the dangers of splitting 'conventional' and 'alternative' medicine too tidily...

As far as I can see, in India (the main user of homeopathy), homeopathy as practised there is directly derived from Hahnemann (i.e. it was imported from the West); the most notable figure there is Kent and I've added a bit on his views.Gareth Leng 17:20, 20 December 2008 (UTC)

Fourthly, perhaps there is a bit more to be said on the idea of 'homeoprophylaxis', that is, immunization by homeopathy.

OK, tried this in a box - obviously this is the aspect of homeopathy that arouses deep anger in conventional medicineGareth Leng 15:20, 20 December 2008 (UTC)

looks good - useful addition ... Martin Cohen 19:39, 22 December 2008 (UTC)

And finally, is there not more to be said on the role of water itself in homeopathic thinking? This also draws on ancient philosophical views of the nature of 'reality'...

The role of water in homeopathic thinking - I can see how that might explain a lot, but I don't know how to express that suggestion neutrally. :-)Gareth Leng 15:25, 20 December 2008 (UTC)

The 'memory of water' article/stub should be good enough, never mind the 'neutrality'.—Ramanand Jhingade 16:52, 20 December 2008 (UTC)

I admit I don't know what the CZ conventions are, but 'lay-out' wise, the page is very rough. Shouldn't it be put in a 'neat' state now - with boxes replacing somem of the sections (like the Law of Similars) and those missing graphics located? Martin Cohen 13:20, 20 December 2008 (UTC)

(On that last, at least, here's a suggestion: http://en.wikipedia.org/wiki/File:Beydeman_Gomeopatiya_vzir.jpg ) Martin Cohen 13:35, 20 December 2008 (UTC)

-I like that, if it can be put inGareth Leng 14:39, 20 December 2008 (UTC)

While there have been no hard and fast conventions defined, we have been getting some complaints about boxed text. They don't work well with text-to-speech systems for people with visual handicaps, and also may not render well on small screens. This has been discussed on the Forum without a firm decision.

In general, I will use a table when the nature of the information is tabular, but I'd rather have things be accessible than having the most artistically elegant layout. Howard C. Berkowitz 17:17, 20 December 2008 (UTC)

Happy to go with whatever others prefer, but I think boxes are useful if the information is tangential to the flow. It's not just elegance - it's to mark things as asides.Gareth Leng 17:28, 20 December 2008 (UTC)

re. boxes - I also think the boxes are more than just 'decorations' - they are crucial to the usability of CZ. Until there is a general decision taken against them, at which point I presume all boxes would be removed and the code blocked for them!, I'd ask Howard to be careful not to present their use as somehow to be avoided. That would prejudge the issue.

re. Dana's excreta issue! I'm not clear what the issue was, but if it helps, Dana, the quote is in the historical origins section and illustrates the central homopathic idea of like cures like. It may not (one bows to his expertise) be 'homeopathic' in the current sense, but it has historical notability. Secondly, if it helps! I did NOT suggest the addition (although I support it) nor did I make it - Gareth did. Can we have it restored now please?Martin Cohen

Just to clarify; the quote was Ramanand's find and suggestion; he proposed it, I inserted itGareth Leng 19:17, 20 December 2008 (UTC)

I like the boxes a lot for the tngntal issues. If there are issues with repect to "visual handicaps" then we should solve the problem within the box, not just remove them altogether. Howard, can you give us a link to the forum discussion? Chris Day 18:25, 20 December 2008 (UTC)

Chris, we are starting an article that includes these topics. For now, see Usability/External Links for the Forum links. Howard C. Berkowitz 03:53, 23 December 2008 (UTC)

I'll have to search for the forum discussion, Chris. This is really not the place to have this discussion. I may well pull out some of the technical material that has been produced for compliance with the Americans with Disabilities Act and Section 508 of the Rehabilitation Act. Remember the discussion, though, not too long ago, of color-coding links and such, and the number of people who had colorblindness? A blind person can use a text-to-speech converter across a web screen, but the problems of suddenly going into new columns or boxes confuses most such converters. Accessibility is an area where I do have professional experience.

Martin, I am being careful to present the use of boxes from my own professional area of competence, so I'm not "prejudging" but making a suggestion. I am a Computers Workgroup Editor, have been an invited speaker at the Usability Professionals Association, and quite a number of years experience in building computer systems that are accessible. I made a suggestion that boxes can be problematic in web interface design, from my direct professional experience. Not only can they be a problem for people with visual handicaps, but they also can be a problem when trying to print a page, especially when they have a colored background. Howard C. Berkowitz 19:08, 20 December 2008 (UTC)

Some questions on refs while editing

For the material in the text box starting "When a homeopath is conducting an interview...", the citation goes to an article on treating rhinitis, rather than clear definitions of the homeopathic meaning of these terms. Is there a better reference?

Also, the statement is made, "Modern physicians, however, are constrained by ethical codes that forbid them from deliberately misleading their patients; rather than prescribing placebos themselves, some therefore prefer to refer patients to regulated practitioners of alternative medicine. " What code is being violated here? I think we need a citation; I don't think this is in the Declaration of Helsinki. There are some specific things about misleading about risks, especially in a clinical trial, but even "misleading" is vague. After all, it's extremely common to tell patients they have "bad cholesterol", when there's only one kind of cholesterol, but multiple types of lipoproteins. That's vaguely misleading. Howard C. Berkowitz 17:29, 20 December 2008 (UTC)

Ethics example here [3]Gareth Leng 19:06, 20 December 2008 (UTC)

Remember that the majority of U.S. physicians do not belong to the American Medical Association, and this is not even a full AMA position, but a committee. I'd be more comfortable seeing this in the context of an amendment to the Declaration of Helsinki. I really question if a large portion of referrals to alternative practitioners are being made as a subtle way to avoid prescribing placebo. There are some quite specific guidelines about placebos in clinical trials, but clinical practice is another matter. Most literature references seem to deal with trials, but here's one, from a bioethics journal, indicating that placebos may be appropriate in general clinical practice. [4]. I don't know of any firm recommendations, outside clinical trials, in using them, although the cite I gave does put constraints on their use. Howard C. Berkowitz 19:31, 20 December 2008 (UTC)

Declaration of Helsinki is not relevant -it's about medical research. It seems that ethical codes don't bar its use [5] - in the USA about half are willing to. Here it reports in a survay that 60% of British doctors are willing to prescribe placebos [6] (by which they mean treatments that they don't expect to work for the particular condition, including e.g. aspirin). The statement needs modifying I agree - doctors here are taight medical ethics and that it is unethical to deliberately mislead the patient. This is the conflict. I'll reword.Gareth Leng 19:52, 20 December 2008 (UTC)

An article for placebo is on my list. For that matter, the whole issue of physician-patient communications ethics probably is worth an article; there are many issues, some having to do with cultural expectations. Howard C. Berkowitz 20:05, 20 December 2008 (UTC)

Some clarifications

I'm having trouble with "A fundamental reasons for conflict between conventional medicine and homeopathy is that homeopathy rejects the concept of treatments that target common mechanisms of disease, but seeks individualized treatment."

Could people live with removing the last four words? Few physicians would say they do not individualize. Even with a common diagnosis, there are many choices of drugs, which gets especially individualized when there are multiple diagnoses. Howard C. Berkowitz 17:32, 20 December 2008 (UTC)

30C Potency and Hahnemann

Someone wrote in the article that Hahnemann recommended 30C for most situations. I have never heard this. Unless someone can provide a reference, we will need to take it out. What I do know is that Hahnemann primarily used very low potencies for the first 2 decades of his use of homeopathic medicines. When some fellow homeopaths told him about their use of the 200th, 1,000th, and 1,500th potencies, he expressed strong skepticism initially, until he actually tried these potencies himself and found surprisingly good results when properly used according to the principle of similars, not to simple pathology. Dana Ullman 18:59, 20 December 2008 (UTC)

I wrote that so I must have read it somewhere, but not necessarily a reliable source - I didn't register it as potentially controversial. But here is a clear and good source HAHNEMANN'S USE OF POTENCY OVER TIME by Peter Morrell "Finally, we can safely say that Hahnemann at the end of his career mainly used potencies 12, 18, 24 and 30 and that this comprised some 81% of his total prescribing" ....and here ...."In 1816 30c makes its first appearance and this remained for all intents and purposes his most extensively used and most highly recommended potency of all" Gareth Leng 19:11, 20 December 2008 (UTC)

Toxicology

Is there another term that could be used rather than toxicology? Quoting from Medical Subject Headings, toxicology is "The science concerned with the detection, chemical composition, and biological action of toxic substances or poisons and the treatment and prevention of toxic manifestations." Is it a homeopathic term of art? In general pharmacology, the effects of excessive dosages are not necessarily considered "toxic", although they may certainly be "undesirable".

"Toxic" has quite a few connotations for chemical safety labeling, and even in law (e.g., Toxic Substances Control Act [7]).

The usage, as in provings, may be understood in a pure homeopathic context, but I'm thinking of the nonspecialist reader. Is there a synonym that might be less ambiguous? Howard C. Berkowitz 19:20, 20 December 2008 (UTC)

Just take it out - it's certainly not toxicology and there's no term that's readily recognized.Gareth Leng 20:41, 20 December 2008 (UTC)

Latest nudges

I altered the phrasing about "more gentle alternatives" because Hahnemann generally used the same drugs as conventional medicine but at high dilutions.

I've deleted the reference to the Law of molecular concentration - this is the name given to Fick's Law (1858) and doesn't seem to be relevant here - I think the intended allusion is to the Law of Dosology introduced by Grafen Ceasre Mattei (Count Ceasre Mattei,1809-1896) which asserted that the more grave the disease, the more the remedy must be diluted (potentised). I don't know if this is worth mentioning - we can't cover everything, and I don't know how significant this Law is; comments Dana?

Side-effects - these aren't really mentioned, and perhaps it's as well; it's often said that homeopathy has no side-effects and I don't dispute that - but this seems at odds with the method of provings, which records transient symptoms that in conventional medical terminology would be classed as side-effects. Homeopaths also say that remedies often additionally aggravate symptoms - these effects in conventional medicine would always be clased as adverse events (side-effects). Thus there will be a difficulty - clearly homeopaths and conventional medicine are using side-effect to encompass quite different things. If side-effects are mentioned it will be important to note these issues. Gareth Leng 11:11, 21 December 2008 (UTC)

Provings aren't treatments; aggravation, which happens rarely, can't be considered side-effects; homeopaths are generally agreed that homeopathic remedies don't cause 'side-effects'.—Ramanand Jhingade 18:43, 22 December 2008 (UTC)

Mattei's statement is not worth mentioning because the potency issue is much more complex than that, and there is a school of thought in homeopathy that people with severe pathology need frequent doses of low potencies. I personally believe that these are technical issues and don't have a place here.

As for the side-effects issue, this is a bit complex too. You are right that "provings" do create symptoms in healthy people who are sensitive to the substance being tested, but these are not "side effects" (they are the intended and direct effect of the medicine). Separate from provings, homeopathic treatment sometimes creates a "healing crisis" (also called an "aggravation") in which certain symptoms start shortly after a homeopathic medicine is taken. These symptoms are usually "externalizations" of the disease process (i.e. a skin rash, an early profuse and/or clotted menstruation, a productive cough, etc.) or a re-experience of old symptoms (that have been "treated" or suppressed with ineffective treatment). "Hering's law of cure" makes reference to these observations of the healing process after a homeopathic medicine and may desire mention here. Dana Ullman 17:22, 24 December 2008 (UTC)

Need for vital force article

There really is a need for a unifying article on varying concepts of vital force, including non-Western ideas such as qi, and variant Western ideas as in homeopathy, traditional herbalism, naturopathy, etc. I'm not sure if the chiropractic term "innate intelligence" should be covered as yet another variant.

I'm really not the best person to start this; it would best be started by someone from a background outside conventional medicine. Howard C. Berkowitz 18:42, 21 December 2008 (UTC)

see Vitalism, written long back, by me and Matt (imported from Wikipedia days)Gareth Leng 23:27, 21 December 2008 (UTC)

OK, I've redirected to it from vital force. Dana and Ramanand, you may want to make any appropriate updates. Howard C. Berkowitz 00:27, 22 December 2008 (UTC)

Looks rather like what the Theories of Alternative Medicine was working towards too... a link will be useful/ do the job here too. And I'll place it in "philosophy' for future updates... Gareth, I did specifically ask for comments on this page - this sort of feedback would have been useful...

- I commented on the Theories page at length in the Talk, but forgot about Vitalism completely - I guess I didn't see it as specific to Alt Med.Gareth Leng 21:31, 22 December 2008 (UTC)

There is a lesson for all of us in forgetting things we have already written, although I forget what it is. :-) Seriously, I do this myself; before I start an article, I do try to search to see if there are existing topics, at least that should be linked in the article or via a Related Articles page. More than once, I've found I've already written something similar. Howard C. Berkowitz 21:54, 22 December 2008 (UTC)

I shall note that this section of the talk page did not address Paracelsus. Howard C. Berkowitz 18:33, 22 December 2008 (UTC)

Humble apologies, Gareth, of course you provided loads of very helpful feedback there. I've been meaning to thank you but got behind - especially with this! ... Martin Cohen 00:12, 23 December 2008 (UTC)

It appears that Martin deleted parts of the paragraphs above. Perhaps this was an error. If not, it is my understanding that while entire sections of talk pages may be archived by any Citizen, deletion of another Citizen's comments, all or in part, is reserved to Constables. Howard C. Berkowitz 00:23, 23 December 2008 (UTC)

I restored Martin's post above. It looks like there was an edit mistake that accidentally deleted some of Howard's comment and Howard then reverted it. D. Matt Innis 19:25, 23 December 2008 (UTC)

Paracelsus

All: Can we have somne decision on Paracelsus, please? (As summarised above) Martin Cohen 10:51, 22 December 2008 (UTC)

Martin, with all due respect, you have just said that a page on vitalism was useful. It turned out to have been written some time ago, and simply not linked. It was something, however, that was accepted as an axiom while the bulk of the article details were worked out. The discussion was not diverted to it. Virtually everyone who has been a participant in this discussion has given their opinion on Paracelsus. I believe it is fair to summarize that while Paracelsus is a significant figure in the history of medicine, he is not a primary figure in the current Western thinking about homeopathy. There are discussions, on totally unrelated pages, about how much background, history, and philosophy is relevant to a main article. There are times, and I am disputing one, where the history is absolutely relevant -- but it still goes under what might be called an "index" or "top-level" article, and is linked separately from the main article. That is exactly what is done with vital force: it has been an undefined element of the homeopathy discussion from the first draft of the article, and I personally have a sense of completion that the link is no longer red. There are questions I still have about homeopathy, but I am not hammering about them.

Might I suggest that not every article belongs in the philosophy workgroup, or must have the history presented first?

Whose doing either?

Not every article needs a dissertation on eastern and western philosophy? The material should be available for those who want it, but I was able to write, for example, the current new draft of the week, Dien Bien Phu, with a link to an article on the ideological factors of the Vietnamese dau trinh. We don't have an article on colonialism,and we should; it still should be linked. There isn't a good article on containment policy. It was possible to write nuclear weapon without going back to Democritus.

Impossible!

Seriously, this is not a helpful argumentative tactic - ridiculing others's position. The historical development of the 'like cures like' idea, is central to understanding of the "Father of Homeopathy' (the H one - not the P one). It's true we have a link ot a seperate page on the history, so we could skip it here, but IMO a bit of history is a good idea, and the section exists.

There indeed should be links to the ethics of nuclear weapons use, but there is, in the article, reference to that from a pure military standpoint, the need for many nuclear weapons no longer exists.

I really, truly don't understand what "decision on Paracelsus" you want that you have't been given extensively. Could you please be specific on what is lacking?

What I am saying is that the material OTHERS - not me! - added to the piece should be kept there, rather than deleted without giving good reasons or adequate explanation. 'Bad reasons' do not suffice. I also would extend the same general principle to contributions by myself, but as it happens, I have avoided adding text on this to the article as there seems to be a tendency for such to be deleted straight after. For this reason I'm reluctant to add the image mentioned above (and Gareth supported) - but if others can indicate agreement on adding that, I'm happy to do it.

The consensus [on P], as far as I can see, is that a link is all that is really needed.

WADRH (with all due respect, Howard) Pierre-Alain, Ramanand, Gareth and I have tried to add some detail on Paracelus. Even Dana has thought some detail was needed. Who makes up your 'consensus'?

He was mentioned in Bach flower therapy, because Bach expressly mentions signatures. I certainly wouldn't object to symmetrical links between Paracelsus and sympathetic magic. There are many other places where his work is relevant, at least as a link. Are you saying you still believe there needs to be more than a comment and link in this article?

Yup.

I'm honestly trying to understand what you are requesting. Howard C. Berkowitz 14:44, 22 December 2008 (UTC)

I'm trying to clarify the issue. Then we can put it behind us. I thought it was there already until Dana recently re-opened it with his deletion of the plague section and querying of the 'thistles'. Martin Cohen 18:19, 22 December 2008 (UTC)

Dana, I've used, 'Faecalis', the bowel nosode, in the 200th (homeopathic) potency successfully, so I hope you can re-insert that Paracelsus reference-I think it worked (for Paracelsus) on the same principles.—Ramanand Jhingade 18:24, 22 December 2008 (UTC)

I cannot follow your interspersed references well enough to respond. PLEASE: either put your responses in a block indented not more than one space, or, if the indentation goes too deep to read, back to the left by one. If you cannot do this, at least copy the signature of the person to whom you are responding. I'll simply say that I believe the matter of Paracelsus was settled, but it keeps getting reentered.Howard C. Berkowitz 18:32, 22 December 2008 (UTC)

Martin, in due respect, I do not think that your scholarship is good here. Just because one author referred to Hahnemann the "second Paracelsus" does not have the meaning you suggest. Paracelsus was a medical revolutionary, as was Hahnemann, and both were hated by the orthodoxy. That is the point. This certainly does not mean that Paracelsus is or was the "father" or "founder" of homeopathy. What I am concerned about now is that you have been repeatedly told by several people here that they do not agree with you, and yet, you are not listening. I hope that you begin to listen better so that collaboration can be most effective.

And in reference to Ramanand making reference to a single (very rare) homeopathic medicine that is taken from feces does not have a clear reference to the homeopathic principle of similars. Martin's previous point on this was the principle of similars, and I just don't see it. Dana Ullman 05:38, 24 December 2008 (UTC)

Dana, I make no claims for my expertise in this matter, just recording certain factoids. One might throw the accusation back at you, but I won't as I don't think we want this to be a case of 'personal authroities' - surely you are an expert on homeopathy, I am less sure that having stated you knew nothing at all about Paracelus (earlier on this page) you should also take this high stand on his activities here.

Ramanand, Pierre-Alain, Gareth and myself have all contributed material to this page on Paracelus which you have deleted offering only fleeting explanation, usually (IMO) irrelavent to the issue. Over 200 words have been deleted now. This normally requires some degree of explanation and consensus reaching, doesn' it. None has been sought here. No compromise wordings offered. Ramanand, Pierre-Alain and even Gareth have added extra references and supporting material. All of this effort is being discarded.

Here is my suggestion again:

1. We have an historical origins section. (Re. Howard's point of the 24 December - if we didn't well, yes, we could leave the article explicitly NOT covering the pre_H history of Homeopathy). Paracelus and Hippocrates belong in this section. See 'Final Arguments in the Case of Paracelus' above. Numerous citations to this effet, from the Britanica:

"He was the first to declare that, if given in small doses, “what makes a man ill also cures him,” an anticipation of the modern practice of homeopathy..."onwards have been given - see above too. Ramanand and Gareth's work describing the two celebrated historical cases of 'like-cures-like' examples of P using thistles to cure inflammation, and P using excrement affected bread to cure plague should be restored.

Here is the text deleted:

(Paracelsus asserted the healing power of "signatures", meaning that the appearance of a substance in nature (its color and its shape), represented the types of diseases which it could cure. )0This led him, for example, to teach that the pricking of thistles cures internal inflammation, and is sometimes cited as an early form of the "principle of similars". refTheophrastus Paracelsus Catholic Encyclopedia entry/ref In the summer of 1534, Paracelsius claimed to have cured many in the plague-stricken town of Stertzing with pills containing a minute amount of the patient's excreta.ref. Cited by Homeopathy Encyclopedia Brittanica. According to " The life of Paracelsus, Theophrastus von Hohenheim, 1493-1541" by Anna M. Stoddart (1911) "Paracelsus stayed some weeks at Stertzing and was appalled at the ignorance and helplessness of the local doctors... He decided to put his own experience and opinion into writing for the benefit of the afflicted town.... He appended to his diagnosis of the plague a series of counsels as to its treatment and a number of prescriptions and recipes. The little book in four chapters was presented to the " Burgomaster and Magistrates of Stertzingen, ... He received little thanks for his book from the civic worthies, but it is probable that during his stay in Stertzing he practised as one knowing the plague and made enough of money to provide himself with necessary clothing, food, and lodging."/ref

I am trying to follow the 'conflict resolution' process here - advice from Constables appreciated - so I am not going to add the material back myself. But it seems to me that the process has not been respected by others. Martin Cohen 14:56, 24 December 2008 (UTC)

Constable comment: In response to Martin's query, it is my opinion that, now that Dana has responded, the discussion on this page should be stopped and if the author is still not satisfied, the CZ:Dispute Resolution process should be followed and notice that there are specific duties that the constable is obligated to perform according to the section CZ:Dispute Resolution#Procedural issues. Thanks, everyone, for respecting the purpose of the process. D. Matt Innis 15:16, 24 December 2008 (UTC)

Merry Christmas!

Merry Christmas and Hanukkah (to Dana)! May the joy of these festivals dilute our differences/nihilism!—Ramanand Jhingade 16:42, 22 December 2008 (UTC)

Thank you! Are there some Indian festivals around this time that deserve recognition? I'll also add Solstice and Kwanzaa. I've greatly been amused by the reactions of some African friends who think Kwanzaa is quite American, but they like the idea and have added it Howard C. Berkowitz 16:48, 22 December 2008 (UTC)

Everybody celebrates the Gregorian New Year (although non-christians follow other calenders as well), but the next Hindu (not all Indians are Hindus) festival is on Jan.14, when spring commences. If one goes back in time, it can be observed that many Hindu festivals and Pagan festivals of the Roman Empire were celebrated at the same time (probably because both are descendants of the Aryans).—Ramanand Jhingade 18:14, 22 December 2008 (UTC)

Confusing homeopathy with complementary and alternative medicine?

The basis of homeopathy is the using of small doses of products that cause symptoms like those of the disease to be treated (Anonymous (2024), Homeopathy (English). Medical Subject Headings. U.S. National Library of Medicine.). Some of the content of this article and related articles are about herbal medicines that are thought to treat illness through direct, physiologic mechanisms and not be inducing symptoms like those of the disease to be treated. - Robert Badgett 16:22, 23 December 2008 (UTC)

Perhaps a nit on terminology, but the National Center for Complementary and Alternative Medicine does classify homeopathy as CAM. Your point is well taken, as there are some edge cases that may no longer be in this article, where the source referred to using a plant extract but not necessarily in homeopathic dosages. I would welcome your comments at the stub article phytotherapy, which is the preferred MeSH term for herbal medicine, and to which I've made assorted redirects. Howard C. Berkowitz 17:43, 23 December 2008 (UTC)

Can you be more specific, please Robert? Martin Cohen 21:15, 23 December 2008 (UTC)

Has Oscillococcinum, in higher doses, been shown to actually cause influenza symptoms and thus meet the criterion of "Principle of Similars"? - Robert Badgett 03:29, 24 December 2008 (UTC)

Yes Robert. Oscillo has undergone provings, and it does cause flu-like symptoms. This is not at all surprising when biologists note that ducks carry various influenza viruses in their digestive tract, and epidemiologists have confirmed that ducks are flu "reseviors." Oscillo makes sense; there is a body of research to confirm it, and it has a long history of use and success internationally since the 1920s. Dana Ullman 05:29, 24 December 2008 (UTC)

If I understand the technique of provings, the remedy is not diluted, or potentized, as much as in treatment. At the concentration used that produced the flu-like symptoms, and ducks carry influenza virus, was it ruled out, using virological and immunologic methods, that the duck preparation did not contain either virus or antigenic fragments? If so, that could explain the symptoms, although it would be less clear whether a dilution would protect. Just wondering... Howard C. Berkowitz 05:36, 24 December 2008 (UTC)

Howard, actually, provings are conducted usually using potentized doses, most commonly 30C. THIS is why homeopaths consider "skeptics" of the power of the potentized medicine as misinformed or uninformed. These medicines have the power to heal AND they have the power to create symptoms in select (sensitive) healthy people who take daily doses of them. Provings do not usually work on ill people because their body is already busy working to heal them, and they are simply not sensitive to a proving. Dana Ullman 16:57, 24 December 2008 (UTC)

(assuming the above response is from Dana). Thank you. I had misunderstood that provings were now done on potentized varsions; Hahnemann's discussions of quinine, for example, seemed to suggest that pharmacologic doses were used in provings.

As I understand, Oscillo was developed in the 1930s, however, when sensitive virus or virus fragment tests did not exist. This is not a challenge, but serious interest; I wonder if anyone has done PCR or another amplification technique on it looking for viral material. Howard C. Berkowitz 17:15, 24 December 2008 (UTC)

can consumers "practice"? I think not

In the second paragraph, we have: "Although homeopathy is practiced by some medical doctors, as well as other health professionals and consumers in virtually every country in the world...." I question the wording. We say, in correct English, "Doctors practice medicine." We don't say, however, that "Patients practice medicine." So why should we say that homeopathy is "practiced" by "consumers"? We can say "used" or "utilized", perhaps, though this will necessitate rephrasing the sentence somewhat. Hayford Peirce 16:35, 24 December 2008 (UTC)

Hayford, good point, but it is a bit more complex than you may initially realize. First, we should change the word "consumer" here. The point is that there are "professional homeopaths" who are not licensed in any conventional medical or health professions who "practice" homeopathy. Ultimately, because we can and should consider "professional homeopaths" to be a type of "health professional," I suggest that we remove the word "consumer." Dana Ullman 16:51, 24 December 2008 (UTC)

Yes, that makes sense to me. Hayford Peirce 16:54, 24 December 2008 (UTC)

Really friendly amendment

I removed the sentence "Even most surgical procedures have never been proven to be effective through double-blind and placebo controlled trials." From a pure stylistic aspect, it distracts from the flow of going from the true statement that the role of aspirin, a drug, was not understood, and then going to homeopathic remedies, which are much more similar to drugs than to surgery. I think Dana's point is better made without that sentence.

I fully agree that surgical procedures are not tested to the extent that are drugs and some medical devices. Nevertheless, bringing in surgery, along with placebo controls, will bring in side issues, such as the ethics of risk by "sham" (term of art used rather than placebo in surgery) controls versus the risk of a placebo controlled drug trial.

Incidentally, I would suggest avoiding anything that assumes all randomized controlled trials are placebo controlled. They are usually not considered ethical if a treatment believed to be efficacious exists. See informed consent. The basic rule, with specific exceptions, is that if a treatment with some efficacy exists, the best current treatment becomes the control arm. A good example would be several major trials in chemotherapy of breast cancer in postmenopausal women: the control arm used tamoxifen while the experimental arm used aromatase inhibitors. Most of these trials, incidentally, were stopped early and the aromatase inhibitors offered to all patients, as their superiority was judged, by independent reviewers, so great that it would be unethical to keep the control patients on tamoxifen. Ironically, the earlier trials with tamoxifen were halted and the control patients offered tamoxifen because it was much more effective than the standard treatment arm.

There are means of statistically acceptable clinical trials that use neither placebos nor double blinding. It would be my hope that some of these methods could be used with homeopathic remedies. Howard C. Berkowitz 17:15, 24 December 2008 (UTC)

"Tweak" to overview.

I'm sorry, but what was described as a "tweak" is a substantive change, which I see as completely reversing the earlier words speaking of

"Homeopaths are proud of their history, and are convinced of the efficacy of their remedies based mainly on their clinical experience, bolstered by the outcomes of

previous text...some, mainly small trials.

changed text ...the majority of clinical trials.

I reverted to the previous text; this needs to be discussed and agreed-to by all editors. Howard C. Berkowitz 18:31, 24 December 2008 (UTC)

Actually, according to the Linde meta-analysis, the average size trial in homeopathy was 60 subjects. While 60 subjects may not be considered "large," it also should not be considered "small." The bottomline is that the majority of trials DO have a positive outcome. Please note that I have spent a lot of time creating a new body of info on research, and earlier today, I added some of this to the article, plus I will be adding what I think is a good summary of the Shang article and its responses. I tried to write it objectively and look forward to others' input. Dana Ullman 20:34, 24 December 2008 (UTC)

I agree you are trying to create something useful, and thank you for it. If these were non-homeopathic trials, for any common disease, I'd have to call them small. They would be a reasonable size for Phase I trials, and, depending on the disease, orphan diseases being a special case, might be sufficient for a Phase II recommendation to move to multicenter trials. Without going through the specific studies, I'd say "promising and justifying further evaluation" would be fair.

If I were reading about trials of a purely conventional treatment, I'd normally interpret "majority of trials" to imply that they were multicenter Phase III, and showed statistical significance. When Linde's 1999 paper says “There is increasing evidence that more rigorous trials tend to yield less optimistic results than trials with less precautions against bias.” I'd have to be cautious in saying that efficacy was demonstrated. Again without having the paper, let me ask if any of these trials were multicenter, for the same indication?

Again referring purely to conventional medicine, small trials can be very important when there are no treatments at all for a condition, or the trial is for individuals that failed treatment for a fatal disease. If the trials were for something self-limiting, I think there would be an expectation of more rigor. I just don't have the information here to know what "positive" really means, considering the multiple factors of safety, efficacy, and severity of conditions. I'll wait for your additional material. Thanks. Howard C. Berkowitz 20:50, 24 December 2008 (UTC)

It is important to know that high quality clinical trials (homeopathic OR not!) tend to yield less positive results. This is not simply observed in homeopathic trials. A couple of the Oscillo trials were in the Linde trials, both of which were multi-center and with 300+ subjects. Dana Ullman 22:19, 24 December 2008 (UTC)

Comments welcome on changes to placebo article

I have added a substantial amount of text to the prior article on placebo, which I did not originate. That article dealt principally with the use of placebos in randomized controlled trials, not in general clinical practice. Some of the questions I raise below may not strictly deal with placebo, but may be fair subjects for this article.

I am really looking for serious comment and have no hidden agendas here. There are some very challenging ethical issues here.

There are times where a medically prescribed placebo may be, according to some ethicists, appropriate as part of conventional treatment. Inevitably, these issues blur into issues of if and when a conventional practitioner may:

• Refer a patient, whom he cannot help, to a practitioner of a CAM discipline that the physician believes will not be dangerous, but will have no more than placebo effect.
• Refer a patient, whom he cannot help, to a practitioner of a CAM discipline that the physician thinks might be of benefit, although the conventional physician does not understand the mechanisms of the CAM technique
• Discourage a patient from seeking a CAM treatment that the physician believes is ineffective, but is not likely to be harmful. In such a case, assume that the physician has no conventional treatment to offer, or the patient has declined to give informed consent.
• Discourage a patient from seeking a CAM treatment that the physician believes is likely to be harmful, or would be used in lieu of a treatment the conventional practitioner does believe will be of benefit.

In other words, the conventional physician might have cases where she believes the CAM practice is equivalent to the ethical use of placebo. How do homeopaths, especially nonphysician homeopaths, deal with physician referrals? If a patient self-refers, and remains under the care of a conventional practitioner, is there an ethical duty for the homeopath to consult with the other clinician?

Howard C. Berkowitz 00:52, 25 December 2008 (UTC)

Related articles

I, and I believe some other Citizens, are trying to create at least stub articles for CAM topics, and have been trying to use MeSH definitions for it. Much to my surprise, I discovered that MeSH puts homeopathy under several categories, one including spiritual therapies. While I might disagree on other definitions of homeopathy, I personally don't think it belongs under this heading, but, since I was quoting from MeSH, needed to include it. Under spiritual therapies, I did put in a sentence that I thought was a reasonable disclaimer from a homeopathic standpoint, but please feel free to improve it. Howard C. Berkowitz 21:28, 25 December 2008 (UTC)

I appreciate your "disclaimer," but why should homeopathy be listed at all under the category of spiritual healing? I suggest that we delete it entirely. Dana Ullman 16:39, 26 December 2008 (UTC)

Fundamentally, to keep consistent with the major indexing system in healthcare. It's not the only place homeopathy is listed in MeSH.

In discussing CAM in general, several people have suggested that MeSH names be used for consistency and neutrality. This is the first real surprise I've had in following that convention, and I would note that MeSH does have homeopathy under several categories. Now, if the top-level heading was vitalism-based methods, they might have a point. The only reason I think they might have done it is that there is a parallel to sympathetic magic because its classic anthropological statement does include a law of similars.

It's bad indexing; I don't know who does the categorizing, but, having worked for the Library of Congress, I suspect staff but with comments and consultation. Still, I hesitate to make any exceptions from the practice of using MeSH. I will have to check, but there is, I believe, an Editorial Council resolution (passed? I don't know) to use MeSH for biomedical article, and I believe that is the reference Robert Badgett and others use. I really hesitate to start making exceptions. I'd sign a letter to NLM that either it doesn't belong here, or then quite a few other disciplines do. Howard C. Berkowitz 17:33, 26 December 2008 (UTC)

Replaced section

I hope we're converging now on an article that can be approved, and I've had a fresh go at the one remaining section where I can see problems.

Dana, you made a great shot at trying a balanced approach to this, and I've kept all your references in, though some details are down in the notes rather than in the body in line with the intent to leave this section relatively uncluttered. You brought in the Shang Lancet article - I think it was right and inevitable because it was so influential.

There were a couple of problems that I saw, most obviously it wasn't clear a) exactly what the fuss was about with this particular article - a) why did it make such a scientific impact (not just another meta analysis)- what was so unusual about it, b) what exactly was that impact, and how did homeopaths respond.

The "two recent analyses" are not two but one - the lead author is the same, presenting the same re-analysis for two audiences, (and is a homeopath). I've lifted quotes from the JCI article to bring out the conclusions.

Most importantly, I've tried as Dana did to write this section as a report of the controversy, trying not to infiltrate an editorial position. I saw with Dana's version the problem that even when you write neutrally, the order in which things are presented conveys an implicit bias - selecting some things as important to say first. I also saw that there is a problem of choosing what to say - obviously Dana sees the problems with the Shang study as being the important things to get across, from my point of view I see those problems as besides the point, the important point being not that the Shang study showed that all effects were placebo effects - they never claimed this; the important point was that it showed that it was plausible that they could be - and that was not disputed by the JCI study. But I'm not saying that my perspective is better than Dana's - it's just that from different perspectives different things show up as important.

I've tried to avoid this by starting with overtly neutral sentences, and then following a chronological account, keeping to the statements of authors and others, including study critics, trying to avoid interpolating my own interpretations. I've included a lengthy quote from the SVHA because I thought it important to let that argument be heard here, even though it can be argued that it's not relevant to the evaluation of trials.Gareth Leng 21:10, 26 December 2008 (UTC)

Good work, Gareth. However, this material is challenging, and I felt that I needed to place the specific disease meta-analyses into the body of the article, not just the footnotes, because reviewing just the global meta-analyses misses some important and notable specific disease treatment effects. I also felt that you gutted some of the critic of the Shang paper. I still want to edit it further. I don't know if that quote from the Swiss homeopaths is adequately representative because the vast majority of the letters to the Lancet were strongly critical of how Shang selected trials, how he evaluated them, and the limited number of trials in the final analysis (from 220 to 14!). Dana Ullman 03:16, 27 December 2008 (UTC)

Thanks Dana; - on the selection of trials for the final phase - this was intrinsic to the study design as the hypothesis was that larger trials would show less effect than smaller trials - and that the largest would show no effect. Of course whether a selection still shows an effect depends on the cutoff - in a sense this is Shang's point - the higher the cutoff the less of an effect there is.

The Shang study shows clearly that in all trials, conventional or not, the results from small trials are very unreliable. What is a small trial? Virtually all of the trials in the Shang study were small by conventional standards - it's not a representative sample of conventional trials, but a matched sample. To check, I looked at PubMed at the most recent 20 trials reported; 7 had over 1,000 subjects and only 6 fewer than 100 - all of the 6 small trials were rare cancer conditions. The median size was 400.

The SHVA are classical homeopaths - in a later statement they declared that ”Most homoeopathy effectiveness studies do not comply with basic homoeopathic rules, in no way correspond to real treatment practice and are – unlike studies of conventional medicine – irrelevant to practice. These studies are only carried out as external justification for homoeopathy. In real practice the selection of homoeopathic remedies is carried out completely on an individual basis. The remedy does not have a universal effect; rather it proves to be effective for the individual. In contrast, for study purposes, homoeopathic practices are usually distorted and standardised and forced into irrelevant research schemes. The result of this is a considerable risk of obtaining falsely negative results“Gareth Leng 09:22, 27 December 2008 (UTC)

The big difference between the large homeopathic and allopathic clinical trials is that the allopathic trials previously tested the treatment on smaller numbers of subjects and based on positive results, they created a larger trial. The homeopathic trials did not do this, so some trials were simple large pilot trials. Testing Oscillococcinum for the "prevention" of the flu is a good example. The study was actually conducted by a French company that was competitive with Boiron (makers of Oscillo) to test their product (with the SAME ingredient) as a preventative...but it doesn't work well as a preventative medicine, only as a treatment method.

And for unknown reasons, Shang, et al chose to include only 1 treatment trial with Oscillo, even there are THREE trials with over 300 (!) subjects. The exclusion of these other trials was never addressed.

And yes, we are making good headway here. I am confused why Gareth deleted the specific reference I provided that noted that 3 (!) of the 8 allopathic trials showed efficacy of a drug in the short-term but these drugs were removed from the medical marketplace later on when they were found to be more dangerous than effective (this fact suggests that "efficacy" of allopathic drug trials provides only a partial picture of their effects.

Finally, Gareth, I appreciate ALL of the time you are devoting here, but can I ask you to make a greater effort to type something in the Summary for your edits? Dana Ullman 17:08, 27 December 2008 (UTC)

I thought my edits accepted that some drugs that pass efficacy are subsequently withdrawn because of side effects - you didn't give a ref (that's what I thought - Did I delete a reference - if I did I'm sorry, hadn't intended to, I'll check) to this so I deleted the specific phrasing (I couldnt verify) but I'm not saying its not correct - but what's the point here? Seems irrelevant to the issue of whether homeopathic remedies are placebo effects or not - so I acknowledged the point (in the last para, its likely to be true, it's what I'd expect) - but it's not germane to the issue of efficacy. Gareth Leng 21:47, 27 December 2008 (UTC)

Yes, on checking there's no reference for this point. Happy for something like this to be in a footnote, but not with that precise wording - the Shang analysis was not a comparison of conventional medicine and homeopathy, wasn't designed that way - it was purely and simply a test of the hypothesis that the effects are placebo effects - in this sense, for them the conventional medicine analysis was simply a "positive control" - to show that their approach was capable of factoring out publication bias. So saying that it wasn't a fair comparison of conventional medicine and homeopathy is missing the point - it didn't try to be a comparison, and we should avoid suggesting that it was one. It is also true that some of the conventional treatments were ineffective - as should be the case. Trials are done to weed out ineffective treatments, that's their purpose.Gareth Leng 22:02, 27 December 2008 (UTC)

Whooops...I didn't mean that you deleted any reference. My concern was that you deleted the specific fact that 3 of the 8 trials used drugs that were withdrawn. To me, just saying that "some" drugs were withdrawn wasn't specific enough (having 3 of the 8 withdrawn is significant). Dana Ullman 03:54, 28 December 2008 (UTC)

Appreciation

Dana and Gareth, I'm impressed with the way the Shang et al discussion is developing.

Not here, but perhaps in the "Overview" wrapup, would there be any point in mentioning some alternative controlled trial approaches that are being considered for low-responder or such things as individualized genomic medicine? As I understand the blinding mechanism for such trials, they essentially are testing the diagnostic and remedy/drug selection process, as opposed to the remedy/drug itself. The clinician determines whatever treatment would be appropriate, and then sends that order off to the pharmacy. The pharmacy, in turn, opens the next random assignment envelope, and either prepares exactly what was ordered, or a control preparation. I'm inclined to think that these will need to be placebo controlled rather than best-existing-treatment, for how would you define the latter?

The U.K. Parliament report to which Gareth referred me does discuss such alternatives to traditional RCTs.

Just a thought; if homeopaths think this is a potentially fair means of future testing, and there's at least some discussion on this, it might be worth mentioning. Howard C. Berkowitz 08:23, 27 December 2008 (UTC)

Interesting thought, but think its better to cover that in the trials article - we shouldn't here get too tied up in the testing issue, and now we're close to approval I'd rather close this article down for further major editing. Gareth Leng 10:41, 28 December 2008 (UTC)

Good idea; good place. Howard C. Berkowitz 17:27, 28 December 2008 (UTC)

Absolutely silly aside I had to share

Don't worry, if you are not a Star Trek fan, this will make no sense whatsoever. It may or may not even make sense to fans.

As I've been reading this, I remember Gareth's institution is in Edinburgh. Now, I don't know if he himself is Scottish, but the discussion of the trials is bringing up a very odd mental image. I'm visualizing an alternate-universe version of the original Star Trek, but with a Dr. Scott and Chief Engineer McCoy. I hear, Gareth, playing the Doctor, saying to Kirk:

Kiptin, ye canna violate the laws of experimental design!

I haven't yet figured out if Dana is playing Kirk or McCoy.

If I find myself in this vision, I must be Mr. Spock, muttering "fascinating".

Howard C. Berkowitz 18:01, 27 December 2008 (UTC)

I once gave a lecture as "Capt. Dana T. Kirk" of the Star Ship Enterprise. I'm glad that you see me possibly as Capt. Kirk rather than a tribble...or some other alien. We are making progress. Dana Ullman 03:57, 28 December 2008 (UTC)

"It's life Jim, but not as we know it!"  ??Gareth Leng 10:41, 28 December 2008 (UTC)

yes or no, did Hippocrates ever say "like cures like" or not?

I looked at the origins of this article (several years ago, as a matter of fact) and although the "like cures like" has been there from the start, there was no mention of Hippocrates in the first months of editing.

When did he make his appearance, and who did the editing? And what is the sourcing for this? Martin, over in a Forum discussion, is making the flat assertion that this is 100% false.

For a flat statement in the lede paragraph, we ought to make doubly certain that it really is correct.

What's the story on this? Hayford Peirce 18:39, 28 December 2008 (UTC)

I don't know 'for sure' it is wrong, but it is very unlikely. Here is the page for the quote in the Forum. It is such a complicated link it may not work - we shall see,

http://books.google.co.uk/books?id=1Wez4pgWp3AC&pg=PA96&lpg=PA96&dq=hippocrates+text+%22like+cures+like%22+hippocrates+'like+cures+like'&source=web&ots=0iJ2zp9j2q&sig=ODWqxhd4_ddm8DHzIGhaeJd9EJU&hl=en&ei=HYFWSc60J-KYjAfYlcSsDw&sa=X&oi=book_result&resnum=1&ct=result

Note also that Hippocrates' approach is quite opposed to the homeopathic idea. This is directly linked to Paracelsus who i have argued about already as the key 'populariser' of this idea - but am not supposed to be able to raise again, so I won't! Martin Cohen 20:46, 28 December 2008 (UTC)

Well, here's a quote from someone apparently at the Univ. of Michigan, writing in something called Medicina Antiqua at[8]

Hippocratics find it important to absorb all human diseases within their medical technê, including the very difficult sicknesses of sudden seizures and premenarchic madness, and to this end they not only assign mechanical causes that interact with the anatomy and physiology they endorse, but they also employ therapies that reverse a diseased condition in accordance with the same mechanical principles. "Opposites cure opposites" is a deliberate intellectual stance in opposition to the "like cures like" of sympathetic magic. Hippocratics know how to speak the language of science, and they are certainly the first in the Western tradition to write medical science in a form that has survived to our time.

I don't know how conclusive that is, but I think that it indicates that whoever put in the Hippocrates citation ought to source it pretty carefully for us. Hayford Peirce 21:11, 28 December 2008 (UTC)

Hahnemann has quoted Hippocrates in many of his books, notably the Organon. I hope someone can find some of those quotes online (I don't have the time).—Ramanand Jhingade 03:01, 29 December 2008 (UTC)

I'm increasingly dubious about this assertion. We have to put our sources into hierarchies, for the following reasons:

• If we had a primary source, ie, a surviving work by Hippocrates stating this, that would be no-brainer.
• If we had a secondary source, such as Thucydides, circa 450 BC, writing in an aside to one of his works on history that "the noted Hippocrates has stated that etc. etc.", that would be a pretty good source.
• If all we apparently have are citations of Hahnemann supposedly quoting Hippocrates, that, to me, is not a very reliable source. In fact, I would say that it is no source at all.
• If Hahnemann is going to be the only source for this assertion, then I think that we should absolutely remove it. This doesn't mean, to be absolutely fair, that at some point you can't say that "Hahnemann said that Hippocrates etc.", but it certainly should not be in the lede paragraph as a flat assertion that Hippocrates said it. Hayford Peirce 04:38, 29 December 2008 (UTC)

William Howard Taft did have a pygmy hippopotamus in the White House. If he used homeopathic remedies, is that close enough? I can source the hippo part. Howard C. Berkowitz 05:02, 29 December 2008 (UTC)

Skipping the above, I agree with that. In this case, a direct statement by Hippocrates would be needed, interpretations by others are irrelevant. I know of no such direct statement, but Dana thinks he can come up with one. Well, fine if he can, but Hayford is surely right to shelve the claim for the time being. Even a 'category 2' reference requires a rewrite of the claim, which makes it a bit too weak to justify prominence - eg. According to so and so writing x hundred years later, Hippocrates believed that ... Re. Dana - there is nothing 'odd' that I think Paracelus promotes the principle and Hippocrates does not - or is there some subtle contradiction he could explain? Martin Cohen 18:50, 29 December 2008 (UTC)

Adding to Philosophy Workgroup

Following Matt's comments in the Forum, I believe it is appropariate and uncontroversial to add this to the Philosophy workgroup. For information, I would say the parts that are philosophical here are those concerning the general theory 'like cures like', the historical development of basic underlying concepts and ideas concerning human health and nature, and certain peculiar features of homeopathy, such as the question of how somehting with no active content in conventional terms can affect health. Most of the article, don't worry! is well outside 'philosophy'. Martin Cohen 20:54, 28 December 2008 (UTC)

Res ipsa loquitur. Howard C. Berkowitz 21:04, 28 December 2008 (UTC)

I cannot remember if I am the source of the reference for Hippocrates or not, but I am 100% confident that the previous reference was accurate. Hippocrates was a medical historian who reported on different treatments used in his time. In fact, he may have been the first to report that some physicians used the principle of similars in treatment. Medical historian Harris Coulter devotes much of volume 1 (of his 4-volume treatise on Western medical history) to the Hippocratic writings, and he gives specific references. I will see if I can find them. I did look at the link that Martin provided, and I consider that source to be dubious because he asserts that like "never" cures like but only aggravates the condition. This author clearly doesn't understand the use of small doses of like to cure like. It is also a bit surprising that this reference would come from Martin who has previously championed Paracelsus who also recognized the value of the principle of similars. Dana Ullman 05:00, 29 December 2008 (UTC)

I have confirmed that the above book reference given by Martin was material derived from the writings and thought of Galen, who lived 400-500 years after Hippocrates. Galen believed in using opposites to cure. Hippocrates, however, recognized numerous instances when using similars was vital. For example, people who had a fever needed warm or hot remedies, not cold ones. He referred to this as "coction," a process in which the fever is burning something out, and the body needed help in this coction process. Harris Coulter notes in Divided Legacy (volume I, p. 206) that "cure by similars, which had been suggested in the Group I and IV writings (of Hippocrates) is developed extensively. Not only are fevers treated with heating remedies, expectoration and coughs with medicines which provoke expectoration and cough, and phlegmatic diseases with liquids, treatment by similars is proposed as a general principle: diseases are caused by similars, and by the similars which he takes the patient is saved." Dana Ullman 19:23, 29 December 2008 (UTC)

On adding this article to the Philosophy Workgroup: no. I agree with Howard on this one: res ipsa loquitur. But I'll say a few things. Even if Hippocrates were deeply important to this article, it would establish nothing, since most philosophers, even specialists in ancient philosophy, do not study Hippocrates; I imagine classicists and historians of medicine do. And another thing: Martin's reasons would ultimately make it possible to add the Philosophy Workgroup to every article; that won't happen. Similarly specious reasoning can be imagined for adding the History Workgroup to the management of nearly every article. Anyway, please consider the question decided. By the way, Martin, your "and uncontroversial" beggars belief--it's hard to believe anyone could really think the suggestion would be "uncontroversial." If you wish to contest this, please don't discuss it here on this page. Propose a new resolution for the Editorial Council--if you can get anyone to support it, that is. Please just drop this suggestion; I don't want us to waste any time discussing it. --Larry Sanger 20:27, 29 December 2008 (UTC)

Adding Philosophy as a workgroup - utter nonsense at this stage. Thnis article has been developed as a key article of Healing Arts; this is its primary home as written, it might have been written another way for another home, but it wasn't, and adding workgroups at this stage is unacceptable. I'm happy to delete Hippocrates fix the wording or see it fixed, but this is a trivial point. Dana, on the article as a whole I'm generally happy if you are to put it up for approval? Gareth Leng 21:48, 29 December 2008 (UTC)

As frightened and amazed I am to say it, yes, it is there or almost there. Some subarticles might be opportunties for development. I want to go through now with an eye to copy and flow edit, but it is very close. Hmmm...the rules do say you need 3 editors to approve if all have worked on it. If you need a third, define it as a war and I'll give Military approval. :-) Howard C. Berkowitz 00:08, 30 December 2008 (UTC)

Flow editing -- looking at last paragraph of intro

Did some text get deleted here? As I remembered, perhaps incorrectly, one of the characteristics of classical was that it would only use one remedy at a time. User-friendly was intended to be for the over-the-counter remedies that could be self-selected by a layman.

Was there not something inbetween, which covered the use of multiple remedies by a professional homeopath, or possibly homeopathic techniques being used in a complementary manner to other disciplines?

If I rememeber incorrectly, does anyone else see problems with the transition between the two sentences? Howard C. Berkowitz 00:32, 30 December 2008 (UTC)

Yes, I think some stuff has been deleted but as far as I can see, there's no problem with the present flow. Hayford Peirce 00:41, 30 December 2008 (UTC)

I have no idea who changed those definitions of "classical" homeopathy and "commercial" homeopathy but both were not accurate. I have corrected this, but I may want to improve them. I also need to give the article a look-over, though we have all done a fine collaboration. Dana Ullman 05:43, 30 December 2008 (UTC)

Thanks. I'm glad I spotted something was off, even if I didn't know what. I'm sure that sort of error crept in elsewhere, and it's going to take fine reading. At this point, I'd say that whenever something seems "off" in phrasing or flow, it's worth mentioning neutrally and see if it's an edit error. Not my stuff, of course. My riteing is Prefect. Howard C. Berkowitz 05:50, 30 December 2008 (UTC)

Howard, are you getting a lot more funny these days or am I simply learning to appreciate your odd (and wonderful) sense of humor (with no regard of Galen's take on humors). Dana Ullman 17:51, 30 December 2008 (UTC)

I shall be phlegmatic in response. Howard C. Berkowitz 18:00, 30 December 2008 (UTC)

Enormous improvement in a mere 90 character

Dana, the rewrite around syndrome, constitution, and psychology makes it immensely clearer. Howard C. Berkowitz 06:49, 30 December 2008 (UTC)

Thanks

Special thanks to Hayford for his assiduousness and to Howard for his alertness and good humour.

I really think we're close, after Dana's careful and balanced mopping operation. Matt is a Healing Arts editor, and Larry an everything editor - so with Dana and myself we seem to be replete. Lets go for Approval, and end what's finished very amicably on a high?Gareth Leng 18:12, 30 December 2008 (UTC)

Does this mean that if I find another AE variant to be changed I can still do it right up until the final Approval, or are things frozen even will the Approval process is ongoing? Hayford Peirce 18:16, 30 December 2008 (UTC)

Hayford, what will happen is that Gareth or Dana will put it up ToApprove and will give everyone some time to look it over and make their tweaks (somewhere between 3 to 14 days perhaps). If at anytime one of the editors does not like what they see, they can remove the ToApprove tag and we start over. If the date is reached, the article then becomes approved and frozen in place. A copy will be made and further changes will be made to the 'draft version'. This draft will then to be re-approved by the same process. Meanwhile, the approved version is the version that the public will see.

For me to become an editor on this page, I think I will need some sort of special clearance because I acted as a constable. I think the conflict of interest clause was to keep a constable from forcing his wishes on the article. If anyone feels that I have, then it probably is not appropriate for me to be the third editor. So, if it is okay with all the necessary powers to be, I'll be honored to take part. D. Matt Innis 18:33, 30 December 2008 (UTC)

Under the circumstances, I think it will be fine. --Larry Sanger 21:54, 30 December 2008 (UTC)

Okay then, I think it is only appropriate then that I switch hats and only be an editor while someone else takes over the constable duties and I actually read the article and see if I can support it! D. Matt Innis 02:10, 31 December 2008 (UTC)

As long as he can't get out of having the standard horrible picture on the clearance badge. Howard C. Berkowitz 21:58, 30 December 2008 (UTC)

So when did you see my picture ;-D D. Matt Innis 04:36, 31 December 2008 (UTC)

Can someone clarify what happens after the article is approved? Is it still edit-able? Is it edit-able by anyone who signs up on CZ? And by the way, I want to give a shout-out thanks to Gareth for his yeoman's work in mediation and to Matt for helping to keep the "fighting" clean...and to ALL of us for not fighting too much, and even when we did, none of us seemed stuck in fighting mode. This was all quite gentlemanly (strangely, there were no women in this one, were there?). Dana Ullman 22:46, 30 December 2008 (UTC)

Dana, the approved version of the article will be locked with page protection so no-one will edit it and will be the version that the public will see when they type in Homeopathy. A copy will be made and placed under the name Homeopathy/Draft that we can continue to work on behind the scenes. The editing works the same way only the changes will not be seen by the public until the article gets re-approved by three editors again in which case that may be next week, next month, next year, or never again. At this point, I think we should only approve the main page and not the subpages so we can continue to work on those subarticles. Did that help? Otherwise, read through CZ:Approval Process. D. Matt Innis 02:10, 31 December 2008 (UTC)

Thanx. This process make so much sense. Bless Larry! Dana Ullman 03:58, 31 December 2008 (UTC)

Gangrene?

Friends, can I suggest that we change this example from gangrene (a very rare condition these days...and a very medical condition in any case!) to a more common contemporary ailment such as ear infection or to hayfever? Dana Ullman 22:36, 30 December 2008 (UTC)

I agree a more common example would be better. Having been involved in lab support for some cases of gangrene, I wish it were less common. May I never see, or, especially, smell it again. Still too often as a complication of diabetes.

On a more cheerful note, hayfever? What's the normal temperature of hay? Howard C. Berkowitz 23:13, 30 December 2008 (UTC)

Happy to see hay fever as well - I put gangrene in, mainly to show that homeopathic remedies were used for serious and rare medical conditions as well as common, generally mild ones; I think this is important to show, but do add a more common example as well.Gareth Leng 11:36, 31 December 2008 (UTC)

Cuban study

A heads-up...I just added a reference to what seems to be an important study on homeoprophylaxis that was sponsored by the Cuban government and that involved 5 million people. Other editors are encouraged to review the abstracts at the reference provided, though the details of this study are not expected to be published until some time in early 2009. Dana Ullman 23:05, 30 December 2008 (UTC)

Larry, this is exactly the kind of thing I meant when, in part, I answered your "should we have a CAM article" with "if for no other reason than health policy and economics."Howard C. Berkowitz 23:13, 30 December 2008 (UTC)

Friendly amendment on double-distilled water

Having done a fair bit of biochemical preparations, I would avoid being specific to "double-distilled". "Chemically pure", "Purified to Pharmacopeia standard", or other term might be safer.

Real-world example: we had a project in the physical chemistry of hemoglobin, where the pH of the water was critical. The receiver bottle's vent had a soda lime trap on it, to prevent CO₂ absorption. The solution preparation was done in a glove box under nitrogen. They were then sealed and typically taken out with a hypodermic syringe and injected into reaction ports, never being exposed to air.

Given clathrates have been suggested in the memory of water, it might be wise not to lock yourself into a single means of water purification. Small gas molecules are typically in the center of clathrates; some ocean scientist friends have told me there are significant, and even potentially dangerous, accumulations of methane clathrates on the sea floor. While I haven't researched it, I'd assume there could be carbon dioxide clathrates; there are even clathrates (might have been the first discovered) of inert gases such as xenon.

Howard C. Berkowitz 23:47, 30 December 2008 (UTC)

Let's figure this out. I thought that "double-distilled" refers to a specific process of distillation twice that is "purified to Pharmacopeia standard." It seems (to me) that we cannot say the latter without saying the former. Dana Ullman 03:49, 31 December 2008 (UTC)

Seems to me we just say whatever is done. Frankly, "chemically pure" only makes sense if it is understood that below a certain concentration trace elements are irrelevant - there's no known process that can yield water without trace quantities of many other substances. If concentrations of less than 10(-12) matter, then there is no pure water.Gareth Leng 11:44, 31 December 2008 (UTC)

Citing one's own books

Let me share some things I've done. We probably should have a policy, since there are a fair number of authors here.

In one case, where one of my books is a general reference to the field, I put in on a bibliography page, along with those of some colleagues [9]. In that case, I chose not to annotate the books, although, depending on someone's needs, I'd recommending having 3 or all of the listed books.

I'm embarrassed to mention that I can't find where I did it, but when I had a specific page referenced, I put a disclaimer on the talk page. At the time, someone pointed out that while these weren't strictly peer reviewed, they were through major publishers with known technical review structures, and that helped.

Actually, looking at the BGP bibliography page, I realized I never went in and filled in the NANOG presentations, which I need to do. I'll refer to mine along with some others. This is easier since these are all public domain.

In like manner, I've never worried about citing peer-reviewed work of mine.

As a suggestion only, unless you are quoting pages or figures, I think it removes any appearance of conflict of interest to have some comment encouraging readers to get further information in the bibliography, and have several authors there.

It may depend on how wide the market for the book may be. I think Milton Beychok cites some of his own work, but I doubt the definitive book on stack gas emission engineering is making Tom Clancy insomniac worrying about lost royalties.

Anybody else here have books? How did you handle it? This is probably a good forum discussion. Howard C. Berkowitz 00:02, 31 December 2008 (UTC)

Howard C. Berkowitz 00:02, 31 December 2008 (UTC)

I'd encourage you to look up our existing policy on this.  :-) --Larry Sanger 04:07, 31 December 2008 (UTC)

Larry, had I known there was a policy, I wouldn't have guessed. Perhaps I searched under the wrong term. Would you mind giving a link? I found some material about peer-reviewed material being OK, and I remember some discussions about textbooks and monographs that went through a review process. I was not at all sure about books meant for a wider audience. Howard C. Berkowitz 04:15, 31 December 2008 (UTC)

CZ:Policy on Self-Promotion and there are long debates about this in the forums from last year, or maybe it was early this year, I forget. --Larry Sanger 20:56, 31 December 2008 (UTC)

Okay, I took a good look at it as well as our policy on self promotion and the way I see it this way. 1) It is in the section that Gareth wrote, or at least finely formatted, so he is acutely aware of the reference, and 2) Though the web link is definitely a promotional page, it lists some 'famous people' that we are claiming have some relationship with homeopathy. It is borderline, but if we think that it isn't anything different than if we were to point to a 'google books' page, then its not so much of an infringement. I think that the link requires that the reader copy and paste it into their browser is in good taste. So, I'll leave it there. D. Matt Innis 15:13, 2 January 2009 (UTC)

which government?

A recent edit about a conference in Cuba says: "a manufacturer of conventional vaccines for the government." But which? Cuban, Brit, 'Merkin, Chinese? Hayford Peirce 01:51, 31 December 2008 (UTC)

That needs attention if it's to stay a)I'll check out the conference links but b) conferences aren't peer reviewed and the status of what is reported there is at best weak (and hopelessly weak if the conference is basically volunteer)Gareth Leng 11:24, 31 December 2008 (UTC)

It's a Cuban business that manufactures sboth vaccines and homeopathic products (for the Cuban government). The conference is not peer reviewed in any form, the scientific committee is wholly Cuban, the abstracts give bare details, not enough for any evaluation - they are mere guides to what is being presented. The link as given doesn't work but this does [10]. So I'd say that this is unhelpful except in establishing that there are still homeopaths who think that this works. It's not helpful as a source of information. I'll look up details of the specific (and I have to say rather bizarre sounding) Cuban programme against the perceived threat of a Leptospirosis outbreak after flooding in 2007, see if I can find an informative account.Gareth Leng 12:22, 31 December 2008 (UTC)

Leptospirosis is an emerging infectious bacterial disease common in tropical regions (spread by rats, risk factor is contamination of water after flooding), generally mild and flu like, mostly transient and mild, more severe forms normally well treated with antibiotics. No vaccine except in Cuba, produced by the Finlay Institute - used since 2004. Cuba had epidemic levels of leptospirisis in 1994, subsequently falling dramatically - but, with hurricanes in 2007, the Cuban government was worried about the possibility of a repeat epidemic. They distributed 5 million doses of a homeopathic agent also produced by Finlay. There seems to have been no extensive mortality that year. So? Was it the vaccine? was it the homeoprophylaxis? or did the sewers survive this time? Or was conventional treatment better this time? Who knows. I don't recommend mentioning it unless it is worth noting that the Cuban government thinks it worth trying this.Gareth Leng 12:51, 31 December 2008 (UTC)

Dana has very helpfully sent me a couple of slides from the Conference that help ne piece together what happened (thankss Dana) - in 2007 the Cuban Government started a campaign against leptospirosis in 3 provinces, Los Tunas, Granma and Holguin where there had been outbrealks of Lep with (in 2007), more than a hundred cases (in LT and H anyway). The campaign involved vaccinating 290,000 in risk groups in 2008, and giving (in 2007), 2.1 million people 200C nosoLep and in 2008 1.8 million nosolep 10MC (2 doses to each person). In 2008 the number of cases was about 20 in LT and H -- don't know what happened in G.

If they're vaccinating the at-risk groups, they clearly don't think the nosode is as effective as a vaccine, but obviously it's much cheaper. With about 200 cases/year in an outbreak, covering the at risk groups may be effective - it doesnt spread from person to person as far as I know, just rats to man.Gareth Leng 10:03, 1 January 2009 (UTC)

A key sentence that MUST be agreed upon by all editors

"Why do many trials report positive outcomes for homeopathy, but some show no effect, and how is it that the positive evidence does not persuade most scientists and leaders of academic medicine?"

The word "many" has been changed, back and forth to "most", "a majority", etc., over and over now. It is a *vital* word. What is the final consensus on it? Hayford Peirce 02:04, 31 December 2008 (UTC)

Good questions..."many" suggests a non-majority, while "most" refers to a majority. The BMJ (1991) and the Lancet (1997) meta-analyses found that most studies showed a positive effect. Dana Ullman 03:54, 31 December 2008 (UTC)

The BMJ (1991) evaluated 105 trials, 81 of which showed a positive result. I don't have the 1997 study in front of me, but I remember it being a significant majority too. Dana Ullman 03:57, 31 December 2008 (UTC)

I agree with Dana, I think there's no question that on a simple count most published trials are positive. It's right to be straight and clear on this.Gareth Leng 11:26, 31 December 2008 (UTC)

I'm fine with 'most' and since 'most' would be a 'majority', I wouldn't split hairs unless it was something really close like 51% to 49%. So, Ill go with whatever Dana feels comfortable with. D. Matt Innis 18:57, 31 December 2008 (UTC)

Which They?

In the "Who are the professional homeopaths", we have this sentence:

• Classical homeopaths place emphasis on the patient's unique symptoms and their psychological state, and they gather this information from an interview, typically lasting from 15 minutes to two hours, with one or more follow-up consultations of 15 to 45 minutes. Consultations of these lengths are comparable to conventional physicians using their clinical judgment, rather than shorter visits demanded by third-party economic constraints. They place more emphasis on the way the patient experiences their disease rather than only diagnosing the disease...

The bold They seems to be referring to 'conventional physicians', but I know that is not what we meant. D. Matt Innis 02:58, 31 December 2008 (UTC)

This list needs a title or something to introduce what it is trying to convey

• A physician qualified in both homeopathy and conventional medicine, after diagnosing a chronic condition that does not medical urgency, will usually first prescribe a homeopathic remedy which he feels may be more effective and is likely to have fewer side effects than conventional drugs.
• Homeopaths recognize that trauma might require conventional medical attention but may complement the conventional treatment with homeopathy.
• Homeopaths disagree with conventional medicine about the role of immunization and chemoprophylaxis for infectious diseases and prefer to prescribe homeopathic remedies that they believe will strengthen a person's immune and defense system.
• Homeopathic practitioners prescribe remedies for people who suffer from various disease states. For some disease conditions, such as asthma and acute bronchitis, remedies are often prescribed not only to alleviate chronic symptoms, but also to treat acute attacks. Homeopathic remedies might also be used after an asthmatic episode with the intent to prevent recurrences.
• An adequately trained homeopath is expected to recognize symptoms that indicate an acute and potentially fatal condition. The practitioner is expected to have emergency medical training and equipment appropriate to his or her level of training in the place of practice (e.g., dressings and basic airway management tools for an individual with training at the Emergency Medical Technician (EMT) of Basic or higher level, and preferably an automatic external defibrillator and advanced cardiac life support resources generally accepted as appropriate for an office. Potentially serious acute ailments may require medical supervision, but homeopaths sometimes prescribe remedies either for adjunctive use or as alternatives to conventional treatment.

D. Matt Innis 03:20, 31 December 2008 (UTC)

Changes to ToApprove version

Okay, I've made my first go-through and agree that you have all done a really good job in transforming this article. I made some changes to the version that Gareth approved and subsequently Dana and Hayford also changed. The difference between the version that Gareth is willing to approve and this current version is this. I'll take a break for tonight (here) and let everyone look it over again before I go through it again. D. Matt Innis 04:17, 31 December 2008 (UTC)

Many many many thanks Matt.Gareth Leng 11:48, 31 December 2008 (UTC)

And to you, too, Gareth! My part was the easy part, you guys did the tough stuff! D. Matt Innis 16:48, 1 January 2009 (UTC)

The lead

I did not make any substantial content changes to the lead, but I did re-arrange it so that it flowed from idea to idea. There were two sentences that I combined as we were repeating somewhat. D. Matt Innis 20:53, 31 December 2008 (UTC)

Congratulations to all of you

Yes, this is one of the greatest achievements for CZ (and for mankind, obviously). Entertaining, provocating, contrasted, cautious, courageous.

Happy new year to all of you. --Pierre-Alain Gouanvic 08:49, 1 January 2009 (UTC)

I agree! I think we ended up with something quite uniquely 21st century! D. Matt Innis 16:45, 1 January 2009 (UTC)

Changed ToApprove version?

Okay, I cleaned up the things that I was concerned about and can endorse this version, which makes changes over the version that Gareth has on the ToApprove template. Gareth, if you are happy with the net changes, please change the version number in the ToApprove template and I'll sign on. Dana, if you have any content changes go ahead and Gareth and I can choose to accept them or not and we can go from there until we all agree that we can put our names to this. Meanwhile everyone can keep copyediting, but anything content related will require all three of us to sign off on it again. Any questions, just ask. D. Matt Innis 16:45, 1 January 2009 (UTC)

math brackets in section "Preparation of homeopathic remedies" - did I louse up something vital?

I was trying to change all the British single quotes ( ' ) to 'Merkin double quotes ( " ) in this section and encountered weird problems when I changed them within two math brackets. I can't see that these brackets do anything, so I removed them, then changed the quotes. Everything seems fine now, but I wonder if I removed something vital? If so, just revert this entire page back to the previous edit. Hayford Peirce 17:36, 1 January 2009 (UTC)

I put in the math notations to help the N= and other statistics stand out a little better from the text; it was not a total success. As long as the typography makes it clear there are formal numeric values here, not just text, anything that achieves that is fine. Howard C. Berkowitz 17:44, 1 January 2009 (UTC)

Ah. Well, I don't have a clue as to what it's *supposed* to look like. Is it satisfactory as it now stands? Hayford Peirce 18:05, 1 January 2009 (UTC)

Looks OK to me. Howard C. Berkowitz 18:56, 1 January 2009 (UTC)

Hippocrates/Paracelsus?

I don't have a lot of time - but honestly...

The early Greek physician Hippocrates of Cos (c. 450 BCE - 380 BCE) [8] was a medical historian who is considered to be the "father of medicine". He wrote about many healing practices, one of which homeopaths assert relied upon the use of "like to cure like."

The only reference is to the Internet Encyclopedia of Philosophy! The text on this page has nothing to do with the claim.

This is amateur night stuff. There are other vague unreferenced claims in the lead paragraph.

I have supposedly an ‘appeal’ in progress - I was told to Gareth! - over 200 words or so of detailed evidence for Paracelsus’ role instead of Hippocrates in the history of homeopathy - but Gareth is pressing for approval now! Well, if the article is ‘approved’ with misinformation sourced on nothing and ommissions justifed by vague claims of all-pervading expertise, we have an encylopedia that is [i] worse [/i] than Wikipedia in that it presents poorly researched material as authorative. To sum up, the writing s of the Hippocratic corpus do not (as far as anyone has been able to show) offer any support for homeopathic principles, and I have offered detailed evidence to the contrary.

The article is in many ways commendable - but it is not ready to be approved. Doing so seems to be a way of cutting off debates which merit further consideration. Martin Cohen 20:30, 1 January 2009 (UTC)

I'm having a hard time finding what you want it to say. I seem to remember that we aren't going to be able to say Paracelsus is the "father of homeopathy', etc., but it does credit him. What else do you want it to say. Why don't you write it here in a couple of sentences and let's see what it looks like. D. Matt Innis 21:35, 1 January 2009 (UTC)

Although I can find reasons to hope that this could work, I share Martin's concerns about the process he's been included in. The process of appeal would be cancelled. Perhaps the process could be reactivated and led to a fortunate end if Martin could be referred to our own authority on Hippocrates, Anthony Sebastian. Both Martin and Anthony have a solid knowledge of the history of ideas of this era. The first two textboxes in Anthony's article on Hippocrates are excerpts of the Timaeus and Protagoras (Plato)!

I hope Anthony could join on the alternative medicine theories page as well.

--Pierre-Alain Gouanvic 22:06, 1 January 2009 (UTC)

There is nothing about approval that stops us from continuing to work on the article. Why wouldn't we reach a good conclusion on this? If it doesn't look like we can decide it before it reaches approval, we can still approve and then re-approve once we make the decision. Is there more than these two sentences?

Good suggestion about Anthony, I'll check with him. D. Matt Innis 22:25, 1 January 2009 (UTC)

I look forward to Anthony's feedback. Please make certain that he says what I wrote above on December 29th. I couldn't help but notice that Martin never responded to this evidence. I contend that is presently written is accurate, and our information on Paracelsus is similarly accurate. I too am not clear what Martin is actually proposing. I previously wrote in the section about the philosophy workshop:

I have confirmed that the above book reference given by Martin was material derived from the writings and thought of Galen, who lived 400-500 years after Hippocrates. Galen believed in using opposites to cure. Hippocrates, however, recognized numerous instances when using similars was vital. For example, people who had a fever needed warm or hot remedies, not cold ones. He referred to this as "coction," a process in which the fever is burning something out, and the body needed help in this coction process. Harris Coulter notes in Divided Legacy (volume I, p. 206) that "cure by similars, which had been suggested in the Group I and IV writings (of Hippocrates) is developed extensively. Not only are fevers treated with heating remedies, expectoration and coughs with medicines which provoke expectoration and cough, and phlegmatic diseases with liquids, treatment by similars is proposed as a general principle: diseases are caused by similars, and by the similars which he takes the patient is saved." Dana Ullman 23:29, 1 January 2009 (UTC)

how about a compromise that will settle the matter but please no one except me? a modest proposal

I really have no ax at all to grind in the great Parac./Hippocrates on-going arguments. It seems to me, from what I have read from all sides, and from what I've found by doing some Googling, is, get this, NEITHER of these two characters should be included in the article. The evidence for EITHER of them being a so-called "father of homeopathy" seems extremely feeble to me, particularly since all the evidence provided by either side is of the "he said that so-and-so said that so-and-so really *was* the father of this and that." I can't believe that any peer-reviewed journal of history would ever permit either assertion to stand in an article.

So, here's my proposed compromise: let's remove BOTH of them from the present article. And let's get the article approved. While that is happening, you gentlepeople who actually DO advocate the inclusion of one, but absolutely not the other, can go back to your researching, and maybe you can find some citations that might convince the rest of us that your argument is actually correct and that your man *does* merit inclusion. And that inclusion could eventually be made to the approved article.

And further, we could all make a New Year's Resolution: "I vow not to spend the following year, all 365 days of it, arguing about this extremely picayune, and to 99.9999% of the general population, totally unimportant point." Hayford Peirce 22:18, 1 January 2009 (UTC)

Another alternative is to simply say that modern western homeopathy was defined by Hahnemann and drop out earlier general references. Proposal: There exists an article, history of homeopathy. Move the precursor arguments there, and let this move on.In this case, a number of participants have worked quite hard, for months, to get the article to an approval stage. The rather painful process focused on describing the modern practice of homeopathy.

It was not necessary to discuss Roentgen to write radiology. Quite a few solid articles on infectious disease fail to mention Koch, Pasteur, or other pioneers. The various cardiology articles short-change Harvey. Pathology doesn't have to go into Virchow or da Vinci. I suppose some might take rib surgery back to the Garden of Eden, but, in general, thoracic surgery journals manage to get by without. Not all articles, on all topics, must go back to the earliest history. Howard C. Berkowitz 22:26, 1 January 2009 (UTC)

Let's follow this good advice for now and once we have a final on this we can revisit the approval. And I accept that "vow of apicayuness". D. Matt Innis 22:42, 1 January 2009 (UTC)

No, I took another look at it. There is nothing inherently wrong about what we have written, we do acknowledge that 'homeopaths assert that Hippocrates said "likes cures likes"' so it is okay for now. Let the dispute resolution process take its course. We can re-approve once we have it settled. If some other editor wants to remove it, that's fine. We technically don't have the three editors on board yet, anyway and any editor can remove the ToApprove template from the top, but I personally don't see that it is worth holding back approval. D. Matt Innis 23:01, 1 January 2009 (UTC)

Hippocrates

1) It seems obvious that Hippocrates is so often cited as a pioneer of homeopathy that we must say this. Certainly Hahnemann admired Hippocrates 2) Hippocrates' writings do not as far as I have found out contain much to support this - the closest I have found is in this sentence (in relation to epilepsy) "And the most of them are curable by the same means as those by which they were produced" but soon followed by "he must strive not to feed the disease, but endeavor to wear it out by administering whatever is most opposed to" [11]

It seems that Hippocrates in some cases believed that diseases might be treated by the same things that caused them, but not as a general rule. Insofar as he had a general rule it was that opposites cure. So the text that I've modified is as far as I can verify - Hippocrates incidentally was not a historian as far as I can see, and none of his original writings survive.Gareth Leng 11:01, 2 January 2009 (UTC)

On Paracelsus; Martin is quite right that Paracelsus has a far more significant role that Hippocrates in the history of homeopathy. Hippocrates is mentioned here because a) he is notably claimed by both homeopathy and medicine as a founder. What is noteworthy is the claim. Primarily this article is about homeopathy as it is practised today; - what is said about it, and how it is explained. Paracelsus' work was known to Hahnemann and certainly influenced him, but as far as this article is concerned those are facts that are of no great relevance to homeopathy today. So an editorial decision has been made on the scope of this article, not on the facts and interpretation of Paracelsus' role. The scope of the article under Citizendium rules, is something that editors should be expected to decide.Gareth Leng 11:18, 2 January 2009 (UTC)

As you mention, Gareth, Paracelsus and Hippocrates both have roles in the (deliberately capitalized) role of History of Homeopathy, for which there is an existing article that is a perfect place for this controversy. As you suggest, the current article is about homeopathy as it is practiced today, to which neither Hippocrates nor Paracelsus are particularly important.

Now that we are approaching consensus and approval with the core team, I think it might be possible to consider sub-articles that were areas of tension in the past. For example, I had wanted some of the 19th century homeopathy and then-mainstream medicine material to move there, but some of the anger between the disciplines made it more relevant to the main article. At some point, we might reexamine that, but not now. As another aside, the integrative medicine article is intended to describe collaborative rather than antagonistic relationships, so if, hypothetically, homeopaths do not at all work with mainstream physicians, it would simply not be within the scope of integrative medicine.

I do, incidentally, have a start on a phytotherapy article (stub only in mainspace), which I would normally have done as an evolving draft in mainspace, but avoided given some ongoing challenges and controversies. In that article, Paracelsus has a much more clear role in the ancestry of some Western herbalism. In other words, I'm not trying to erase Paracelsus where relevant. In like manner, the nature of a Wiki is that not everything needs to be in the main article. I started articles on bile, and, while Hippocrates spoke of cutting stones, I didn't see it as particularly relevant to a modern discussion. Indeed, I even wrote radiology without mentioning Roentgen. Both, of course, would be relevant to history subarticles. Howard C. Berkowitz 15:19, 2 January 2009 (UTC)

Gareth's changes are a definite improvement all around. I've done some searching as well and agree that Martin is standing on firm ground when he makes the argument. Others apparently agree as this controversy is discussed here. Reading through the discussion on that page gives the impression that the we likely should at least mention the controversy for the sake of this article, but that is it. The rest can go into some other article more attune to that subject. I think Gareth's change is as close to the controversy that we should get in this article for now, but keep trying after we approve as well. I am changing the date on the template to the 4th. D. Matt Innis 19:20, 2 January 2009 (UTC)

I'm not suggesting that the argument is incorrect, but I am suggesting that its details are outside the scope of the main article about the present state of homeopathy, which reasonably goes back to Hahnemann, but not before. Is there a consensus that the details of what may have influenced Hahnemann is appropriate for History of Homeopathy, but does not merit, in this article, anything much more than:

Samuel Hahnemann defined the term homeopathy and the methods of provings and potentiation. Certainly, he did not create the idea without connection to the history of medicine, his observations, and an abstraction of what he saw as the principle of similars rather than the principle of opposites. Earlier writers, including Hippocrates and Paracelsus, contributed to the body of knowledge on which he drew. He did not, however, state, in his primary works, that they were drawn directly from principles drawn from these or other sources. There is no evidence, from his contemporaries, that he did so. See History of Homeopathy for a discussion of how those earlier ideas may have influenced his thinking.

Just some draft wording. Howard C. Berkowitz 19:35, 2 January 2009 (UTC)

I think Howard's proposed revision is right on the money. Hayford Peirce 19:52, 2 January 2009 (UTC)

Apropos of not much, I rather like Matt's edit summary from his change to the metadata, "One more day"...goes off singing "One more day to revolution" from Les Miserables... Somehow, that sounds appropriate. Howard C. Berkowitz 20:00, 2 January 2009 (UTC)

Actually, this revision is not accurate. Hahnemann was a serious academician, and he is very specific on who he references and who he didn't. He referenced Hippocrates, though he did not reference Paracelsus. Hahnemann did not provide these references in his books, but he did so in the articles that he got published in academic journals of his day. Quoting from one of the leading biographies of Hahnemann (by Richard Haehl, MD, Samuel Hahnemann: His Life and Work, 1922, p. 81, volume I): "Hahnemann then relates with the hlep of his great scholarhsip, how and by swhom the principles of homoepathy have been applied in former times. He goes back to Hippocrates and his school ('Illness arises by similar things and by similar things can the sick be made well; vomiting can be made to cease by means of emetics') This passage, quoted at greater length, reads as follows (it is referred to in the 'Allg. Anz.', No. 245, 1822).

Then, on page 273-4 of this same volume, I quote: "When Trinks (a homeopathic colleague of Hahnemann), from his own narrative, pointed out to Hahnemann whilst visiting him in Kothen in 1825, that the main features of homeopathy were to be found in Paracelsus, Hahnemann replied that it was unknown to him. In a letter to Stapf, Hahnemann refused very definitely and with some indignation to be associated with Paracelsus's fantastic and none too seriously written.

In the light of these issues, I recommend that we revert the article to what was previously written. Dana Ullman 20:52, 2 January 2009 (UTC)

Hippocrates, Paracelsus, homeopathy: Suggestion

Methinks this issue requires further scholarship:

• We need to study the entire piece in the Hippocratic Writings where "like cures like", or the like, resides, and then decide how to present the information to the reader.
• Same regarding Paracelsus.
• See where Galen fits in.
• Delve into the literature on other cultures thought to perform treatments adumbrating homeopathy.

Forgive me if this already covered in History of homeopathy, which I have yet to review.

Suggest we wait to deal with above until the draft version following approval.--Anthony.Sebastian 22:50, 2 January 2009 (UTC)

See my suggested compromise 'historal origins' beginning

See my suggested compromise 'historal origins' beginning. Feel free to reject. --Anthony.Sebastian 23:16, 2 January 2009 (UTC)

We can settle controversial historical issues in History of Homeopathy. --Anthony.Sebastian 23:18, 2 January 2009 (UTC)

Complete agreement. They are not the thrust of the article, and are no more necessary to describe the current practice than Harvey needs to be cited for diagnosis and treatment of heart failure, or Roentgen for computerized tomography. I think cholecystectomy can be mentioned without reference to Hippocrates cautioning against cutting for stones. Howard C. Berkowitz 23:24, 2 January 2009 (UTC)

Addendum

I have just been formatting the addendum subpage. I know that no author is given but as an addendum subpage this text would be open to editing. Shouldn't this text be preserved, as published by the NCCAM, on a signed article page? Chris Day 23:42, 2 January 2009 (UTC)

Chris, I agree. Editing could destroy NCCAM's report. Please do whatever necessary to prevent editing, excepting formating. Addendum sections, or better, the Talk page, could be used for commenting on it. --Anthony.Sebastian 01:08, 3 January 2009 (UTC)

External comment on Homeopathy

See: http://homeopathyresource.wordpress.com/2009/01/17/citizendium-providing-a-better-definition-and-article-on-homeopathy/ --Anthony.Sebastian 18:39, 26 January 2009 (UTC)

Excerpt:

Dana Ullman the main homeopathic representative, has written a number of books on homeopathy and has a Masters of Public Health. He has many years of experience in the homeopathy field. He worked on the new article and definition on Citizendium. The result overall is good- http://en.citizendium.org/wiki/Homeopathy.

In a recent release Dana Ullman writes:

As much as I love wikipedia for certain subjects, its article on homeopathy is truly awful. If you have ever read Wikipedia’s article on homeopathy, you probably got very confused and quite angry. You discovered an extremely biased anti-homeopathy article that was full of misinformation. Such is the problem at present on wikipedia which is edited by anybody, and in fact, the vast majority of people who edit there do so under pseudonyms, some of whom work for drug companies, some of whom are bored teenagers, and some of whom are closed-minded skeptics. Luckily, there is a NEW good and viable alternative to wikipedia called Citizendium.org (www.citizendium.org). This site was founded by one of the two gentlemen who started wikipedia, Larry Sanger. Larry was concerned about the misinformation on wikipedia written by anonymous people, many of whom are not experts. Therefore, on Citizendium.org, he requires every author to edit under their real names. He and the Editorial Council grant authority to those people who are real experts and gives them the position of “editor.” An article remains in “draft” stage (and is not readable by the public) until three “editors” propose acceptance of the article to an “Editorial Council.”

Larry Sanger personally asked me to participate in Citizendium in order to help create a high quality article on homeopathy. Needless to say, this was a real pleasure, as distinct from the “edit wars” typical of wikipedia. That said, other authors and editors on Citizendium are not necessarily “pro” homeopathy, but they are not nearly as vehementally antagonistic to homeopathy as are so many people who participate on wikipedia. I am pleased to announce that after many months of collaborative efforts from a variety of advocates and skeptics of homeopathy, the article on homeopathy has been accepted by the Editorial Council. You can now read it at: http://en.citizendium.org/wiki/Homeopathy

I encourage people to consider using www.Citizendium.org rather than wikipedia if you want to obtain more accurate information about a subject. I also encourage people to consider becoming an author at Citizendium. Information on how to sign-up is provided at this website. Authors can now further improve this article by editing the DRAFT version until this next version received support from three editors and then acceptance by the Editorial Council. THIS is a rational process. And finally, the efforts on Citizendium to COLLABORATE rather than attack is admirable. –DANA ULLMAN, MPH

The contents of the article on Homeopathy on Wikipedia is controlled by the theorizing, skeptical, critics who have never tried Homeopathy. Anybody who is pro-Homeopathy is banned. I hope someone can change that!Ramanand Jhingade 13:27, 11 February 2009 (UTC)

A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

Please confer with the Constabulary if you have a complaint to make about another person or the professionalism of another person's comments. --Larry Sanger 03:21, 13 February 2009 (UTC)