Talk:Homeopathy/Archive 15

Homeopathy

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Next step

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

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

EU and labels

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

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

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

See article 14 of the cited source: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32001L0083:EN:HTML

Let me know if you interpret it differently. D. Matt Innis 02:19, 9 December 2010 (UTC)

Are you talking about Art.14(1)? It is only about "a special, simplified registration procedure", not a rule for all remedies. --Peter Schmitt 23:47, 11 December 2010 (UTC)

Yes, do you interpret that the "special, simplified registration procedure" is not the procedure for the OTC remedies that are the subject of the cited sentence (below)?

• The European Union allows remedies to be sold OTC if they are prepared according to the European Pharmacopoeia or the pharmacopoeias used in the Member States, and if they are at least 3X (i.e. they may not contain more than one part per 10,000 of the mother tincture or more than 1/100th of the smallest effective dose of an active substance); no specific therapeutic indication may be given on the product label.

D. Matt Innis 00:24, 12 December 2010 (UTC)

As I read this the producer may also choose the "normal" registration procedure (instead of the special simplified one), and then this restriction is not imposed. --Peter Schmitt 02:34, 12 December 2010 (UTC)

Unless we can verify that this is the regulation for OTC medicines, the sentence needs to go anyway. I don't get the impression that the regulation is saying anything about OTC. My searches seem to agree with you that "the other" method of registration is available for any dose as well (in which case they could label with a therapeutic benefit on the label). I'd still remove the sentence until we can reword it properly. D. Matt Innis 03:38, 12 December 2010 (UTC)

Removing this may be the best solution. Obviously, the situation is complicated - regulations in detail may be different from member state to member state. However, in Austria many (all?) remedies can be bought in pharmacies OTC, and they usually (always?) are labelled with a purpose. --Peter Schmitt 10:03, 12 December 2010 (UTC)

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In the section "A typical homeopathic visit":

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

should probably read

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

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

"might prescribe a remedy rather than a conventional medicine (which they feel may be ineffective and/or likely to have side effects)."

Homeopaths consider that the conventional medicine "may be ineffective and/or likely to have side effects", not their remedy.

D. Matt Innis 01:38, 9 December 2010 (UTC)

Yes, I have misread the sentence. --Peter Schmitt 23:47, 11 December 2010 (UTC)

Case study on objectivity

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

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

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

The current draft has:

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

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

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

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

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

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

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

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

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

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

Fascinating indeed. In due respect, the very fact that you chose to quote Simon Singh, a well-known strong antagonist to homeopathy, is clearly evidence of a strongly biased point of view. Further, the word "equivocal" is the PERFECT word in the light of THIS article that shows both positive and negative trials and meta-analyses.

If Sandy thinks that the grammar is off, then fix it, just as I fix many of others' sentences...but the fact of the matter is that the LEDE should provide a summary of what is in the article...and the term "equivocal" shows my OBJECTIVITY.

As for the term "sympathetic magic," this term is only used by the most extreme antagonists to homeopathy...and I personally cannot remember many references to it in respectable journals and academic reviews. Further, I had previously quoted Emil Adolph von Behring (the "father of immunology" who discovered the tetanus and diptheria vaccines), and it was HE who acknowledged the link with homeopathy and immunology. To therefore say that homeopathy is "unfounded" is to baste in bias...and sadly, Sandy's statement above is infused in this, which has no place in an encyclopedia.

Please note that the term "unfounded" is extreme, especially in light of this article which shows so much connection between homeopathy and modern day (and futuristic) medical thinking. Dana Ullman 06:10, 8 December 2010 (UTC)

I disagree with almost everything else you say above, but I do think the von Behring quote, and the Osler quote discussed above should go back in. Sandy Harris 06:48, 8 December 2010 (UTC)

All, if we were to go into that much detail on each argument, the article would again outgrow the interest of the average reader. We have to narrow the focus of this article to an introductory article on homeopathy. The Osler quotes and entire argument would be quite important and appropriate for the History of Homeopathy or even the History of Medicine article. Some of the other points that Dana makes can be made in related pages as well with links back to this one.

The changes that I see to the lead are again driving us back to where we were before. I am quite sure that we will now see a skeptic response that will double the size of the arguments without adding any value. The bottom line is that the reduction that Gareth has given us states the homeopathic position in a positive light and the science and mainstream positions in a similar light. He has removed fluff and gruff from both the homeopathic and skeptic viewpoints and boiled the arguments down to their lowest common denominator. It is neutral, objective, concise and an improvement over the current approved article. The new information can remain in the draft where we can continue to manipulate the text until we get it the way we want it.

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

Matt, I put a considerable amount of attention to correcting minor and not-so-minor errors in fact and grammar issues. I also feel strongly that the lede MUST be changed from that edition you want to get approved because the term "unfounded" is a black-and-white term that has no place in a good encyclopedia. Further, that 3rd paragraph is NOT an adequate summary of the review of research described in this article. I personally thought that referring to the research on homeopathy as "equivocal" was objective and appropriate. That said, I'm open to something that says that homeopathy is "inadequately founded"...but to say that it is "unfounded" suggests that there is "NO" foundation to homeopathy (and this article shows that this is simply not true. Dana Ullman 03:59, 10 December 2010 (UTC)

Dana, my expertise is not on the science. That is Gareth's domain. My donation is assuring that the art and alternative ideas are stated accurately. I think this article does state the homeopathic position in a positive light and you have done a good job stating it. We have to allow the same for the scientific and medical outlook. Surely you agree that most scientists and the majority of the medical community consider homeopathy to be on shaky ground. They think chiropractic is as well, but most have a distorted view of what we (and you) do. We're not advocating that they are right in this view, only stating what their view is. To state anything else would be wrong. It is up to the reader to decide.

Concerning the new study, it's great, but it's too new and it is only one study. We can't present it as fact, but, again, I defer to Gareth to evaluate the science. I'd be interested to hear what he thinks of your changes concerning the science before I'd change the version number.

D. Matt Innis 05:00, 10 December 2010 (UTC)

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

EC decision pending

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

Remarks on version to be approved

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

Homeopathic response:

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

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

Safety:

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

Scientific foundations?

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

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

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

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

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

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

Peter, I'm not clear what you mean by "moderate" doses, though doing clinical studies that compared different doses would require very large numbers of patients. Most research simply compares ONE dose with a placebo (or with a conventional Rx).

The 2nd point under "Homeopathic Response" should replace the word "by" with "as".

It seems that many people here (and elsewhere) use the word "plausible" in different way. Normally, plausible does not mean PROVEN, but just a possible explanation. There ARE possible explanations for homeopathic medicines in all doses, though there are no "proven" explanations for them in all doses.

"Ponderable" doses means that there is "something there" in the dose, and I referenced a new study from one of India's leading scientific institutions that shows that there IS something measurable in homeopathic potencies, even at 30C and 200C (that is 30 to the 100th power and 200 to the 100th power). Dana Ullman 03:43, 10 December 2010 (UTC)

Peter,

• "This review of research also found that the 21 "high quality"....
  • sentence is in the latest draft and not in the nominated version

• the by can be changed to as with a copyedit once the article is approved.
• "it would be better for mankind-and all the worse for the fishes." This should be an mdash.
  • these can be changed as copy edits once approved.
• "a remedy diluted to more than 12C was assumed to all probability to contain not a single molecule of the original substance.
  However, new research has confirmed that even extremely diluted homeopathic medicines contain ponderal doses of the original substance"
  • Is not in the nominated version.

Ooops sorry -- it seems that (while reading it) -- I happened to change versions without noticing it. I'll have to reread it. --Peter Schmitt 09:39, 10 December 2010 (UTC)

Scientific foundations?

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

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

• • • purely a style issue.

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

Regulation

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

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

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

Clarification

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

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

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

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

Comment by Anthony.Sebastian

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

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To Dana

Dana,

I'm not happy with your last edit to the draft, in which you have added the sentence I removed again, but shall refrain from arguing about it. I must quote Shakespeare's Julius Caesar here though, "Et tu Dané? Then fall scissor".—Ramanand Jhingade 14:23, 10 December 2010 (UTC)

Dana, I've made some changes and I hope you can go through them before you approve what the others are proposing that Gareth, Matt and you approve.—Ramanand Jhingade 15:41, 11 December 2010 (UTC)

APPROVED Version 2.0

A Decision by the Editorial Council

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

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

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

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

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What the hell?

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

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

Removal of Singh ref from draft is misguided

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

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

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

Let's see...

• NHS:

  Homeopathy is a type of complementary and alternative medicine (CAM). CAMs are treatments that are not based on conventional scientific theories.

• Nature: "Degrees in homeopathy slated as unscientific"
• The Evidence Check report and plenty of media reports on it e.g. [1]
• The British Medical Association vote against homeopathy
• The many sources on Wikipedia that say homeopathy is scientifically unfounded

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

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

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

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

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

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