Talk:Alternative medicine/Archive 26

Archive 20

←

Archive 24

Archive 25

Archive 26

Archive 27

Archive 28

→

Archive 30

Ayurvedic Medicine does not advise Suppressing natural urges can be used to heal

Collapse previos section on same topic

- Recent edits by unnamed editor I undid these edits to the lead by an unnamed editor, here, and here. FloraWilde (talk) 21:12, 4 August 2014 (UTC) No need to specify a(n) editor(s) as unnamed, it is customary to refer to an IP editor as an "IP editor" or to cite the IP, but this is not really needed when a diff is provided. Who performed an edit is largely irrelevant in most cases. The refactor of assertion is appreciated. I have usually seen such notices stating "edits that were not an improvement" or specifying why the edits were reverted for example "unsourced", "did not reflect sources" or "made without discussion, consensus needed for such a change" etc. Just making a suggestion for consideration in the future. - - MrBill3 (talk) 12:35, 6 August 2014 (UTC)

Ayurvedic Medicine does not advise "suppressing natural urges of food intake, sleep, and sexual intercourse" to heal or as a treatment of illness.
On the contrary Ayurveda advise, not to suppress such natural urges and describe in detail in the text book of Ayurveda Charak Samhita, that such practice may lead to disease condition.
Further online reference can be found in online version of Charak Samhita at this link - http://www.charakasamhita.com/2010/10/18-harmful-effects-of-not-attending-to.html
Also note that a link to this online version of Charak Samhita is also given on Charak Samhita's wikipedia page.
Thus I had deleted the concern line in Ayurvedic Medicine section, but it was restored by user:FloraWilde.
On basis of above reference I am again removing the concern line "suppressing natural urges of food intake, sleep, and sexual intercourse" from Ayurvedic Medicine" section.
--Drjaydevbaroda (talk) 21:07, 9 August 2014 (UTC)

Brahmacharya means abstinence from sexual intercourse, but perhaps a better phrasing would be "Controlling and moderating natural urges of food intake, sleep, and sexual intercourse". FloraWilde (talk) 21:37, 9 August 2014 (UTC)

Yes. this phrasing is reasonable to Ayurvedic principles. I know this is not forum of general discussion, but I would like point out that Brahmacharya is not advised anywhere in Ayurveda. In fact among eight branches (sections) of Ayurveda, the eighth branch is Vajikaran, which is about Virilification, Science of Aphrodisiac and Sexology. --Drjaydevbaroda (talk) 22:36, 9 August 2014 (UTC)

Drjaydevbaroda appears to be correct. "Suppression" is the opposite of what the above cited source says, and other sources I foud online. An American promoter of alternative medicine wrote - "According to the Ayurvedic perspective, being 'healthy' is more than the absence of disease - it is a... state of vigor and energy, which is achieved by balance, or moderation, in food intake, sleep, sexual intercourse... "[3] The person who wrote this is not a reliable source for Wikipedia; but he is a notable promoter of alternative medicine. I will add in the content with the qualified wording "An American promoter wrote", but it would be much better to remove the qualification, and have a good secondary source (or even a primary source if no secondary source can be found). Do you know of a reliable source that supports what he wrote? FloraWilde (talk) 19:13, 10 August 2014 (UTC)

First of all I would like to say sorry for my hasty edits. As I am new to wikipedia editing, I thought it would be as simple as editing wrong information in your own computer. After I get edit warning I learnt three-revert-rule and other guidelines.

• The sentence (it is a... state of vigor and energy, which is achieved by balance, or moderation, in food..) is essence of one of the Ayurvedic principals. And it is very generalized sentence, so it is hard to find reference in most reliable source (Charak Samhita), as a line or a paragraph.
• So I could not find other source which supports the sentence (it is a... state of vigor and energy, which is achieved by balance, or moderation, in food..) in a raw meaning.
• However I found proper source which is reliable and fulfil the the essence of sentence in different phrase. http://www.takingcharge.csh.umn.edu/explore-healing-practices/ayurvedic-medicine
• Under subsection "What is the Ayurvedic perspective?"
  

Ayurveda is not a "one-size-fits-all" system. Instead, its regimens are tailored to each person's unique prakriti (Ayurvedic constitution), taking into account his or her needs for nutrition, exercise, personal hygiene, social interaction, and other lifestyle elements.

Daily routines, called Dinacharya, and seasonal regimens, called Ritucharya, are recommended. Following these individualized plans help users of Ayurveda attain robust physical health, as well as mental and spiritual harmony. --Drjaydevbaroda (talk) 18:02, 11 August 2014 (UTC)

A potentially useful source with respect to the history of Ayurvedic medicine in the west is B. Sachs "On Hindoo Medicine" The_proceedings_of_the_Charaka_Club (1902) vol.1 p.1 OL 25612826M LeadSongDog come howl! 18:57, 11 August 2014 (UTC)

Its certainly interesting, even if its usefulness might be lessened by more recent scholarly work on the topic. How did you find this? FloraWilde (talk) 16:57, 12 August 2014 (UTC)

While seeking references to improve the above mentioned Charaka Samhita article, I searched for Charaka on the open library, which is often good for older sources. LeadSongDog come howl! 02:46, 13 August 2014 (UTC)

Proceeding with the newly revised version

The present version, as newly revised, gives even greater prominence than before to anxiety about fraudulent health products in the USA, the homeland of the expression "snake oil" in this connection, said to stem from the days of the construction of the "Pacific Railroad" in the 1860s. In the context of the rest of the article as a whole, that may be considered acceptable. But the topic is not "Fraudulent health products in the USA"; it is "Alternative medicine", an expression that came into use about a century later, and it is misleading to construct the article as if there is some definite entity world-wide of which it could be said "alternative medicine actually is ". In the earlier version, this was scrupulously explained after the lead in "Background" section: Treatments considered alternative in one location may be considered conventional in another... Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare. How the term "alternative medicine" came into use was explained in the next section "History", followed by "The NCCAM classification system", and "snake oil" was mentioned, with citations. We should consider putting the longstanding structure for the first two sections back in place. Qexigator (talk) 15:15, 11 August 2014 (UTC)

Agreed as to snake oil. I removed the unsourced snake oil sentence and corresponding image. FloraWilde (talk) 18:31, 11 August 2014 (UTC)

Why delete the link to article? What was "restored"?[4] Qexigator (talk) 19:35, 11 August 2014 (UTC)

I undid my error. FloraWilde (talk) 20:03, 11 August 2014 (UTC)

FWIW, I think the newer organization is better - I would say that a descriptive introductory section is better than one that prominently frames the topic as a definitional issue. That said, the related changes make the article seem much less professional, among other things, so it still needs to be cleaned up. Sunrise (talk) 11:11, 12 August 2014 (UTC)

May we take that as proposing to let the lead stay more or less as is (subject to minor improving tweaks), but with copyedits (+ moves?) elsewhere? You may recall an acceptable lead resulted from aiming at comprehensive brevity for content to be extended in the article's main body, letting the List of Contents serve readers as an outline synopsis, for them to go to what they are looking for at the time. The format and placing of images has introduced some further complications in relation to the text itself, but these are being sorted out. Cheers to you, Arc! Qexigator (talk) 11:41, 12 August 2014 (UTC)

No. The images and examples are discussed in sections above. FloraWilde (talk) 02:40, 13 August 2014 (UTC)

Try and resist, FloraWilde, this odd temptation to misattribute to another things that have not been and things which are not intended. It does not promote confidence in your editing. Maybe Sunrise can be allowed to answer for him- her-self. Qexigator (talk) 17:27, 12 August 2014 (UTC)

No, I wasn't making any comment on the lead, only on the ordering of the first two sections (currently "Examples of alternative medicine practices" and "Background"). Did I misread the subject of this talk section? On the lead, I agree with some of the changes, although I think that the previous arrangement for the first paragraph was better. More generally, a lot of the changes are similar or the same as those which were previously endorsed on this page by a banned editor, and have the same issues as before. Sunrise (talk) 18:30, 12 August 2014 (UTC)

Well, Sunrise, we seem to agree about the lead, but I remain uncertain whether you are saying that "Background" is better before or after "Examples", which is indeed the subject which started this Talk section. Does "banned editor" refer to the socking IP? Qexigator (talk) 18:44, 12 August 2014 (UTC)

(Inserting my response here since this section has two conversations going on at once.) I meant that I think the section currently named "Examples" is better first, because it is better to open with describing the topic rather than describing definitional disputes, unless the definition section is extremely short. Given the complexity of the topic, describing different types of alternative medicine seems like a reasonable way to start off, although I'm sure there are other possibilities. I would also say that both of the sections should have better titles, e.g. maybe "Types of alternative medicine" and "Definitions." The editor I was thinking of is this one - having checked the account, I see it was a block rather than a ban, but IP socking was involved. Sunrise (talk) 02:48, 13 August 2014 (UTC)

Yes, I can follow that reasoning. There were good enough reasons at the time of the previous revisions for what then resulted, but, as the heading to this section indicates, there is no need to trail back through the archives for that, and we are now proceeding with the newly revised version, noting that the lead and other parts have lately had a further series of copyedits and tweaks:[5], [6], [7], [8],[9]. Subject to comments from others, these seem to be acceptable. Yes, I recall the difficult period editors endured before the one you mention was blocked. Thanks for clarifying. Qexigator (talk) 07:38, 13 August 2014 (UTC)

Examples with images should be at the top so readers immediately get an understanding of what alternative medicine is. Otherwise the examples will gradually be buried in a mass of technical words as discussed in sections above. This leave readers with no understanding of what alternative medicine is. Placement of the examples section and images is discussed in sections above. Qexigator did not respond above as to why he/she moved the examples sections to the bottom, then deleted these sections entirely, and the sources. Instead, Qexigator keeps starting new sections on multiple topics already being discussed by others. Please stop. FloraWilde (talk) 20:41, 12 August 2014 (UTC)

Thank you for putting your position. You have been making some good edits here and elsewhere, and you seem to be heavily committed to your point of view. Now, try and understand that others may see some matters in a different way, but not necessarily opposite or antagonistically. None has a right to claim a monopoly of editorial skill and judgment. Try and accept that you alone are not necessarily always and in every way right about this or anything else, and do not persist in attempting to rubbish others, or, for that matter assume you know what is best for readers of this article. There has been more than enough of that already. That is not helpful for the process of editing Wikipedia. In particular, when another editor starts a fresh discussion, do not seek to claim it as a continuation of something else. Others may have a wider perspective. If you do not wish to participate in the discussion in this section, stay away: it's quite simple. Now, you should also stop moving sections about. What are you really up to? Qexigator (talk) 21:03, 12 August 2014 (UTC)

@Qexigator. Starting new sections on topics that are already being discussed on this page, rather than responding in those sections, fragments the discussions. It makes it difficult to see comments by multiple editors on the same topics. It is helpful not to keep starting new sections on the same topics. FloraWilde (talk) 02:46, 13 August 2014 (UTC)

@Sunrise. The previous arrangement of the first paragraph was better, as you commented. It states that alt med is medicine is medicine that is not based on science, then that there are a wide range of practices not based on science, and cites examples of the wide range. It is returned to that, with the other content moved down the lead. FloraWilde (talk) 02:46, 13 August 2014 (UTC)

Child abuse exemption content moved out of examples into regulation section

I moved this content out of examples section into the regulation section,[10] because it does not really exemplify the practice. If there is a better section for it than regulation, please move it to that section.

In the United States, the 1974 Child Abuse Prevention and Treatment Act (CAPTA) required states to grant religious exemptions to child neglect and abuse laws in order to receive federal money. Thirty-one states have child-abuse religious exemptions.

FloraWilde (talk) 02:26, 13 August 2014 (UTC)

This doesn't seem to have anything to do with this article. Perhaps it was pasted into the wrong article entirely when it was originally added? If it does somehow belong here, the text should be edited to explain how it relates. --Karinpower (talk) 03:30, 23 August 2014 (UTC)

It appears to be about regulating the alternative medicine practice called "spiritual healing", where kids are denied access to medications such as antibiotics on religious freedom grounds. The first source is "Spiritual healing, sick kids and the law: inequities in the American healthcare system." - Am J Law Med. 2003;29(2-3):269-99. The article requires payment to read. Perhaps an editor with access can quote from the source on this talk page. Here is a sampling of exemptions in the second source -

A religious healing practitioner is not required to report as neglect of a child the failure to provide medical attention to the child if the child is provided treatment solely by spiritual means through prayer in accordance with the tenets and practices of a recognized church or religious denomination by an accredited practitioner of the church or denomination

In any case in which a child is alleged to be dependent on the basis that he or she is in need of medical care, the court, in making that finding, shall give consideration to any treatment being provided to the child by spiritual means through prayer alone in accordance with the tenets and practices of a recognized church or religious denomination by an accredited practitioner thereof

No child who, in lieu of medical treatment, is under treatment solely by spiritual means through prayer in accordance with a recognized method of religious healing shall, for that reason only, be considered neglected.

No child who in good faith is under treatment solely by spiritual means through prayer in accordance with the practices of a recognized church or religious denomination shall for that reason alone be considered neglected.

A child shall not be considered abused or neglected if... The child’s parent relies on spiritual means through prayer for the treatment of disease.

A child shall not be considered to be abused or neglected, in jeopardy of health or welfare, or in danger of serious harm solely because treatment is by spiritual means by an accredited practitioner of a recognized religious organization.

Our article fails to inform the reader as to how one gets one's religious practitioners accredited in the US, and which religions are recognized by the US or state governments, and which are not. Perhaps an editor with expertise on established state religions in the US can find sources and add content on this. FloraWilde (talk) 18:52, 23 August 2014 (UTC)

FloraWilde, thanks for clarifying. I now see the connection, though it seems fairly tangential to the article. Do you think it belongs? If it is to stay, I think it needs to be rewritten or at least a sentence added before it, to explain (very briefly) what you just said above.

It seems that this article attempts to include a wide number of fairly diverse practices.... "Traditional" healing methods which seem strange to other cultures (ex. children arriving at school with bruising from skin "scraping" used for colds and other conditions in Asian cultures) and Amish families deciding not to vaccinate would both seem to have relevance to this legislation. But it seems pretty disconnected from the semi-mainstream practice of common modalities of alternative medicine. I'm not sure how it should be handled differently in this article, but currently it's a bit of a mess. --Karinpower (talk) 21:26, 23 August 2014 (UTC)

Missing from this article - alternative psychiatry/psychology

Missing from this article is information on the huge fields of alternative psychology and alternative psychiatry, e.g., work of Wilhelm Reich, spiritual psychology, and Psychosynthesis, to name just a few out of hundreds or more. this good faith edit by User:Katecodrington is an example of one of hundreds of such "branches" of alternative medicine of the subcategory alternative psychology or psychiatry. I deleted that edit under WP:Undue, because of its specificity about a single person's "branch", without a source as to it meeting WP:UNDUE for inclusion. But edits like it need to be generalized and put in our article, with reliable secondary sources as to WP:Undue as to which to include and which not. FloraWilde (talk) 14:34, 29 August 2014 (UTC)

Flora, thanks for dealing with that. I have tagged her article submission and notified her of her COI and not to use Wikipedia for self-promotion. -- Brangifer (talk) 15:39, 29 August 2014 (UTC)

I'm not convinced that this article needs to branch out into Alternative Mental Health, but you might find this template helpful:

I would say that these topics have been covered elsewhere nicely. --Karinpower (talk) 15:18, 29 August 2014 (UTC)

Maybe just a couple sentences, with a link to the template/category? Just a thought. -- Brangifer (talk) 15:39, 29 August 2014 (UTC)

The problem with just a couple of sentences is... (I have no source at hand on this, but) all alternative medicines are essentially "psychological". None is based on physical reality. Sitting a person down in a Wilhelm Reich orgone box to treat depression is "alternative psychiatry", because Reich purported to be a psychiatrist. But this has no difference in physical reality from a Reiki hand waver fixing some Chakra misalignment causing the depression, sticking an acupuncture needle at the right point to treat it, aligning a spine for it, or going to church and getting hands laid on, all to the same end of treating the depression problem. But our article puts the former in a different category, (as does NCCAM, but with same the ultimate end of getting funding for "research" or generating insurance billing codes). FloraWilde (talk) 19:30, 29 August 2014 (UTC)

FloraWilde, I disagree. Your comment uses brush strokes that are too broad. Alt med is a very diverse category, and the modalities within have varying levels of scientific groundedness - from not-plausible to sure-makes-sense-but-scientific-testing-needed-to-prove-it. And they vary quite a bit in whether they are attempting to affect psychology (the mind and the emotions) while some goals that you mentioned about would be more accurately described as "spiritual" or "metaphysical" goals rather than psychological. --Karinpower (talk) 22:00, 29 August 2014 (UTC)

The point I am trying to make is that this article should be broad, and written in broad brush strokes, with links to more specific info. Classifying claims to heal using orgone energy as being psychology, vs. qi, vital energy, Chakras, etc. as physical medicine, makes no sense in objective reality. It should all be touched on in this article. This article is lacking a big chunk of alt med only because NCCAM didn't put much of it on its own list, and this article appears to be mostly written from the NCCAM page. ("Sure-makes-sense-but-scientific-testing-needed-to-prove-it" is called a medical hypothesis waiting to be tested, not alternative medicine.) FloraWilde (talk) 01:01, 30 August 2014 (UTC)

Discussion of guidelines for editing alternative medicine sections in herb and plant articles

There is a discussion of guidelines for editing alternative medicine content in plant and herb articles here. [11]

Note that numerous editors participated, and there is unanimous consensus on editing Wikipedia articles about use of plants and herbs in alternative medicine. (The high editor participation, by editors who each have stellar content editing histories, and each of whom made thoughtful and detailed comments, indicates that the best place to put such on-point topic discussions might be on project talk pages of the area of science that bears on the particular area of alt med practice.) FloraWilde (talk) 14:09, 30 August 2014 (UTC)

Medscape articles

Here are a couple new articles from Medscape dealing with AM/CAM:

• Mythbusters: Complementary and Alternative Treatments in Cancer, Victoria Stern, September 02, 2014 (Full article on one page.)

• Citation template: <ref name=Stern>{{Citation |last=Stern |first=Victoria |date=02 September 2014 |title=Mythbusters: Complementary and Alternative Treatments in Cancer |publisher=''[[Medscape]]'' |url=http://www.medscape.com/viewarticle/830552_print |accessdate=07 September 2014 }}</ref>

• Asking the Experts: Complementary and Alternative Medicine and Cancer, Gabriel Miller, Barrie R. Cassileth, PhD, Edzard Ernst, MD, PhD, September 02, 2014 (Full article on one page.)

• Citation template: <ref name=Miller>{{Citation |last=Miller |first=Gabriel |date=02 September 2014 |title=Asking the Experts: Complementary and Alternative Medicine and Cancer |publisher=''[[Medscape]]'' |url=http://www.medscape.com/viewarticle/830553_print |accessdate=07 September 2014 }}</ref>

Registration is easy and free. Medscape is a good RS, sometimes as a MEDRS, and other times for expert opinions. -- Brangifer (talk) 16:56, 7 September 2014 (UTC)

Real Medicine and Alternative Medicine

I have not noticed any section that says that some modern day treatments (like salicylic acid) are derived from herbal medicine. We should properly note that some well-studied treatments have been discovered to be false, and some to be shown helpful. For starters, the Pacific Yew berries were eaten in North America by natives, and have now been shown to be potential chemotherapic drugs. :) just a though. Qwed117 (talk) 21:20, 13 September 2014 (UTC)

I think this a valid point. how can it be presented in the article maybe a separate section seems logicalDocsim (talk) 14:21, 21 September 2014 (UTC)

This was discussed and resolved by consensus in the section above, Talk:Alternative_medicine#Discussion_of_guidelines_for_editing_alternative_medicine_sections_in_herb_and_plant_articles. Salicylic acid is not "derived from" alternative medicine. Chemist Johann Andreas Buchner in isolated it from Salix alba or a similar plant species in about 1828. When it was scientifically tested using statistical data analysis, the isolated chemical, at the tested dosage level, was found to have therapeutic properties. If some Native American tribe "infused" a preparation from the bark of sufficient concentration, and this was later tested to work at that concentration level, we would say that that tribe discovered this evidence based medicine, not that it is "alternative medicine". If the Native American tribe concentration levels were tested not to be sufficient for an effect, the tribe would not be said to have been discovered it. Either way, it is not relevant to the subject of alternative medicine. FloraWilde (talk) 16:31, 21 September 2014 (UTC)

Im not so sure about that. seems this other editor made a good point. how does medicinal marijuana play into your logic and points just made.Docsim (talk) 10:30, 30 September 2014 (UTC)

Salicylic acid has nothing to do with medical marijuana, so it doesn't. -Roxy the dog™ (resonate) 11:19, 30 September 2014 (UTC)

How does edit summary explain removal of source?

A source was removed by User:Cannolis, with this edit summary - "Reverted 1 edit by User:Jonathan Mcrey: Sorry, what? don't see how this has to do with WP:MEDRS. This article cannot be used to support any medical claims".[12] How does the edit summary correspond to removal of the source? Is there an an ongoing discussion on another talk page? FloraWilde (talk) 12:09, 4 November 2014 (UTC)

Right, that summary was more in response to this one. My original rationale for removing the source was this, which I stand by, I don't think an article that apparently looks at a few case studies meets MEDRS. No further discussion that I'm aware of Cannolis (talk) 13:34, 5 November 2014 (UTC)

Thanks, Cannolis. You are correct. The editor you reverted appears very new, appears to have made the edits in goot faith, and likely does not know what MEDRS is. FloraWilde (talk) 16:01, 5 November 2014 (UTC)

acupuncture

If I read the article right, it says acupuncture (and by extension acupressure) is based on the belief of a supernatural force. My acupuncturist makes absolutely no supernatural claims when talking about treatments: it is all mechanistic.211.225.33.104 (talk) 04:06, 8 November 2014 (UTC)

... and your point is?... Roxy the dog™ (resonate) 08:48, 8 November 2014 (UTC)

Botanica

The image of the inside of a Botanica and its associated text is inappropriate. A botanica is NOT a place for alternative healing, but rather a supply shop for a particular religion and/or magical system. While some alternative healing modalities (i.e. herbalism, faith cures, etc.) may be purchased there, that's not its primary reason for existing. If you include this, then you need to include every religious and magical supply shop here - which is patently ridiculous and irrelevant to the topic at hand. Graidan (talk) 22:58, 15 December 2014 (UTC)

It sure looks like a place which sells various herbs and dietary supplements. That's alternative medicine. -- Brangifer (talk) 08:00, 16 December 2014 (UTC)

Junk addition

Examples:

• "It is based on a fundamental principle of 'DOSHA '- building blocks of the body which can be roughly correlated to biomedical tissue types that conventional medicine seems to be validating in recent years"
• "There are a number of research papers available including on Pubmed and other online sites that seem to validate the efficacy of Ayurveda to a trained eye."

Textbook WP:FRINGE. --NeilN ^{talk to me} 16:36, 19 February 2015 (UTC)

And to top it off, the IP's removing sourced information and adding unsourced claptrap are registered to the U.K.'s National Health Service. --NeilN ^{talk to me} 16:57, 19 February 2015 (UTC)

RfC on COI for alt-med practitioners

Wikipedia_talk:Conflict_of_interest#RfC_on_COI_for_alt-med_practitioners Jytdog (talk) 16:43, 10 May 2015 (UTC)

Biomedicine

Given that biomedicine is mentioned in the Definitions section, would the top be further clarified if it were used there, instead of 'medicine' or as well as? Qexigator (talk) 20:00, 29 May 2015 (UTC)

I added the brief definition of biomedicine using information from the Wiki biomedicine article. FloraWilde (talk) 13:48, 31 May 2015 (UTC)

Definitions section

The discussion above has highlighted several well-sourced definitions of Alternative medicine. I think it would be worth creating a definitions section, similar to Colonialism#Definitions. Yaris678 (talk) 12:55, 14 May 2015 (UTC)

We have such a section - [13] FloraWilde (talk) 15:34, 14 May 2015 (UTC)

Oh cool. I missed it in the contents list because section 1 has so many subsections it was buried. I have used the {{TOC limit}} template to keep things easier to look over. Yaris678 (talk) 15:57, 14 May 2015 (UTC)

Followup on above: I think we should first work on this section, weighting it properly (e.g. most weight to IOM) and then deal with the lede. Both steps may need wider exposure (RfC, noticeboard etc). --Middle 8 (t • c | privacy • COI) 07:29, 24 May 2015 (UTC)

Unfortunately, wider exposure may be more problematic than helpful for a variety of reasons. If adjusting the terms and definitions sections - which seems to be the relevant portion of the article - just try to write a balanced and comprehensive account in readable prose which is well sourced. I'd tend to do that and just plop it in. If you do a good job there's a reasonable chance it may survive. Otherwise, you'll be here until doomsday arguing over every minor proposed edit. The real problem with all the circular discussion is that there's very little ability to look at the article comprehensively, one is stuck all the time whittling fragments while the entire structure of the article appears currently illogical and unreadable (although this is far from the worst iteration of the article and I'm not really criticising any editors here as I almost never properly finish articles myself; it's just a structural problem of the editing process on controversial pages).FiachraByrne (talk) 02:11, 28 May 2015 (UTC)

In the section above, User:FiachraByrne wrote, "I wrote the terms and definitions section". Unreliable sources and POV selection from pre-existing reliable sources, were used to replace (Note: I struck this because a review of the article history shows that User:FiachraByrne did not delete the WLU terminology section, and replace it with something else, as I implied in this comment. The mistake in thinking this was from my own failure to fully check the article history. FloraWilde (talk) 18:17, 29 May 2015 (UTC))

This previous, clear, easy to read, well sourced definition section, by User:WLU, (was replaced by someone, and this (most of which is more appropriate as a subsection on problems with defining alt med.) morass, using unreliable nonmedical sources, and POV selection of fringe "boundary" problems from the otherwise reliable sources in the WLU version, to create the impression that expressions like "alternative medicine", "CAM", "integrative medicine", etc., have little or no meaning to the science based medical community. Unreliable sources added, like Ruggie, falsely assert that "CAM poses huge challenges not only to the dominance of biomedicine... (for which) only about 15% of medical interventions are supported by evidence"[14]. This 15% figure is unsupported by anything. The source is not reliable. Beginning the definitions section with complaints about the "dominance" of science in medicine, is like beginning the evolution article with a complaint about the "dominance" of the sciences of biology , paleontology, and geology, then pointing to the incompleteness of the fossil record.

Rather than usefully defining terms commonly used in English speaking countries for the English language Wikipedia user, the current alt med definitions section starts off by focusing on the WP:fringe area of definition "boundaries". But all definitions have problems at their boundaries, and the same philosophical boundary problems could be used to undefine any Wikipedia article on any subject. This is like starting an article about a plant "species" by pointing out that the concept of "species" is not well defined at the boundaries, starting out an article about "China" by pointing out problems with the international law definition of coastal boundaries, or starting the "table" article with a discussion of quantum physics, whereby the boundary of any particle making up the table is not well-defined.

This does a disservice to Wiki users, who are left with the fringe opinion that the medical science community of MDs and biologists have no idea what and what is not alternative medicine, which is misleading at best. The sources in the User:WLU version are good, and clarify definitions for Wikipedia users, rather than confusing them with fringe boundary problems. I suggest restoring [this] clear section, and letting FiachreByrne's fringe boundary problems section become a subsection on problems with the boundaries of definitions, but after Wiki users are first given the conventional definitions as commonly used in English speaking, with the clear medical sources in the WLU version. FloraWilde (talk) 15:16, 28 May 2015 (UTC)

The above tirade (which is best quietly forgotten, as reflecting badly on its author)) fails to destroy the helpful contributions FiachraByrne has made to the above discussion and to the article. Given the recurring controversies which the article attracts, including misreadings by some coming to it without fully understanding its purport as a whole or in its parts, such as the discussion about Harrison above, the better course is to let the opening paragraphs of the top (lead/lede) stand, while reviewing the content of any section which can be improved with npov updating, when better sources can be found. Skilled writers are sensitive to the inherent ambiguities of language and context, and aware of the need to start an article by encapsulating a set of concepts which will be expanded and discussd later, instead of attempting to write a lexicographical "definition", with the apparatus that is customary in the better and fuller "dictionaries". It would be a mistake to suppose that the top should, in itself, consist of a selection of such definitions, but in the proper place in the article these should be mentioned with an explanation, which the article now contains, about the definitional problem which obviously is not as obvious to some of the less well-informed readers who are looking for npov information on this topic. At their best, Wikipedia articles are written by people who are more in the know for the information of readers who are less in the know. Qexigator (talk) 15:37, 28 May 2015 (UTC)

Hi FloraWilde. For reference, the 'morass', as I left it, looked like this [15]. I'm unclear about the relevance of the Ruggie quote above. The section I wrote on the issue addressed by the quote, since removed from the article, stated: 'This type of [normative] definition fails to adequately differentiate conventional from alternative medicine as, according to a review of Cochrane systematic reviews, approximately 20 per cent of standard medical procedures have no effect and an equal proportion had insufficient evidence to make a determination of efficacy.' This figure corresponds with that provided in the book review of Ruggie by Ernst which you cite above [16]. FiachraByrne (talk) 20:31, 28 May 2015 (UTC)

Hi FiachraByrne. (I copied your "Hi" format because I presume it is what alerted me to your response at the "your notifications" at the top right of my screen.) I called it a "morass" because I went to the section looking for definitions of the many basic expressions used in alt med discussions, and after spending much time reading and re-reading, I could find none of them. The WLU version had brief, readable definitions of

• “alternative medicine”,
• “complementary medicine”,
• “CAM”,
• “integrative medicine”,
• “whole medical systems”,
• “western medicine”, and
• “eastern medicine”.

@FiachraByrne, I presumed when you said you wrote the definition section, that you deleted the WLU section and replaced it with what you wrote. In any case,

It is clear from Yaris678 having started this section that the WLU version with simple, brief, easy to find, basic definitions, should be added back in.

I would suggest going back to having a "terminology" section with simple, brief, easy to find, basic definitions, such as in the WLU version (just bulk copy it back into the article), and adding to the above terms, definitions of

• “medicine”,
• “medical science”,
• “science based medicine”,
• “evidence based medicine”,
• “standard medicine”,
• “conventional medicine”,
• "orthodox medicine"
• “allopathic medicine”,
• “traditional medicine”,
• “herbal medicine”,
• “whole medical systems”,
• “mind-body medicine”,
• “manipulative methods”,
• “body-based methods”, and
• “energy medicine”.

(Since there is consensus for the leads for each article that is linked to, I suggest simply copying the lead first sentence for each definition, if the expression already has a stand-alone article.)

Other editors likely have more to add to the list. But the best way to usefully “define” alternative medicine for a Wikipedia user, is to first list some of the main examples of alt med, grouped such as by NCCAM, which the article already does.

The theoretical, philosophical, narrative section you wrote, going into all of the problems with definitions, is better placed as a subsection of the terminology section titled something like “problems with definitions”. I have suggestions for possibly improving what you wrote, and others might too. But the Wikipedia user who wants to get an idea of what alt med is needs examples. The user interested in more theoretical issues (who has the examples already in their head), should have a basic definition list. The problem pointed out by Harrison and IOM (and by many other sources already in the article), that some (possibly much) of what purports to be medical science, is not founded on science, is a big problem. All alternative medicine is not founded by science. But at least some, and possibly much, of what purports to be medical science, is also not founded on science. But some alt med is pseudoscience, so also purports to be to be medical science. So there is a big inconsistency going on here. This is interesting stuff, but does not belong in a section like what Yaris678, who started this talk page section, looked for and did not immediately find (because definitions of basic terms, if they were in the article at all, were buried. (The whole article, beginning just after the examples section, is a morass. But that does not mean most of its sentences, taken in isolation, do not belong in the article.)

The relevance of citing Ruggie was that it appeared to have been added when you wrote the section, it was not a reliable source. Also, it is false that "according to a review of Cochrane systematic reviews, approximately 20 per cent of standard medical procedures have no effect and an equal proportion had insufficient evidence to make a determination of efficacy". Approximately that many of the procedures selected to be reviewed were unfounded by science. But nothing was said as to how they were selected. Did they look at bone setting methods, antibiotics, or just more fringe or ancient relict practices that deserved scrutiny. It may still be true that such large percentages, or even greater, of medical science should be reclassified as alt med, not medical science. If those procedures reviewed by Cochrane are still practiced, after that review of them found no scientific basis, they should be re-categorized as alternative medicine,like other relicts from pre-scientific western "medicine" such as humoral theory. FloraWilde (talk) 01:26, 29 May 2015 (UTC)

Yes FloraWilde, using a username template sends the user a notification. It's not entirely necessary and I often omit it (as in my other reply to you above) but it is polite, I guess, to notify people when you're addressing them.

I don't believe I'm responsible for the removal of WLU's terminology section but I'm finding it difficult to trace the author of its removal so I can't state that absolutely. It seems to have been moved around quite a bit from early 2013, reformatted, and placed in different sections. IIRC, by the time I did any significant editing on that section, the article was pretty unstable, and WLU's text had been removed. One of the objects of the 'morass' I wrote was to introduce stability.

I'm not absolutely against the reinstatement of WLU's terminology section as you propose but, for reasons of stability if nothing else, it should be prefaced by some brief clause stating 'From the perspective of mainstream/scientific/conventional medicine alt med is typically defined as ...' or some such. Maybe just do it and see what kind of reaction you get.

In the version I wrote, Ruggie was used to support the text, 'Often referred to as complementary and alternative medicine, or simply as CAM,[12] alternative medicine...' (Ruggie, Mary (8 April 2004). Marginal to Mainstream: Alternative Medicine in America. Cambridge University Press. ISBN 978-0-521-83429-2. P. 20) [17]. I think it's a perfectly adequate source to support that statement.

Re the review of Cochrane reviews, it's a statement sourced to a National Academies Press publication on Complementary and Alternative Medicine [18]. It corresponds to the Ernst source you quote above. I think it also corresponds to Bob Imrie's own study of this issue, debunking the 15% figure attributed to Ruggie and others. There may be better and more recent studies of this issue but I'm not aware of them.

Your own definition of what should and should not be defined as medicine or alternative medicine is perfectly valid as an opinion but irrelevant in this context except to the extent to which it is an accurate reflection of the sources. FiachraByrne (talk) 11:59, 29 May 2015 (UTC)

@User:FiachraByrne

• I restored the WLU "Terminology" section.
• I prefaced the first definition with words you suggested for stability - "according to the science community etc."
• I added the definition with an exact quote from Harrison that User:Middle 8 wanted, and I added it the restored "Terminology" section, so it did not get buried in a subsection below.
• I added the definition from the committee report to IOM that User:Middle 8 wanted, with an exact quote from that report. I added it the restored "Terminology" section, so it did not get buried in a subsection.
• I renamed the section discussing problems with definitions to "problems with defining alt med", and renamed its subsections based on a nutshell of their topics.
• The purpose of this restoration and edit is to have a few simple sentence definitions, without a user having to read or think much. What I meant by "morass" is that users like Yaris678 (and me) have to read lots and lots to get to simple basic definitions.
• I reworded the second sentence of the WLU section re "alternative medical systems", citing 19th century medicine, and with a medical history text as source. I reworded it to be more of a "definition of terms". I moved the sentence to below the def of CAM. Almost identical information is in the "problems with definitions" section, but I did not delete that even though it was redundant. You might want to particularly check the rewording since it appears to be something you may have written, and change it back if my rewording is inaccurate or unhelpful. FloraWilde (talk) 21:49, 29 May 2015 (UTC)

Okay. Wait and see how people react. I haven't given it a close reading I'm afraid, so I won't voice an opinion as of yet on whether I think your edits constitute an improvement or not. However, I'd suggest you remove altogether the sentence and source (Bivins) that begins, 'Historians of pre-scientific medical systems...'. It's neither an accurate statement nor does it reflect the source material you're citing. Also, I think it would have been better to maintain the section heading 'Regional definitions' rather than introducing 'Regionally changing definition' which reads poorly. I think I also saw a typo somewhere in the text ('increses' or some such). FiachraByrne (talk) 01:10, 30 May 2015 (UTC)

Restored section added with brief definitions for common terms used in article body and literature

I restored the WLU version just discussed and added very brief definitions for other common terms used in the article body and literature. I retitled the discussion of problems with definitions, and added content about definition problems pointed out by the biomedical community. I made no deletions of existing content. Including block deletions made by Qexigator, the sum total of recent edits are these. Deletions made by Qexigator are discussed in the talk page section below. FloraWilde (talk) 14:06, 31 May 2015 (UTC)

Where is talk page discussion for recent deletion of entire block of sourced content?

This content was deleted. The edit summary was "Trim away unneeded lesser quotes/cites as proposed by another ed. at Talk". @User:Qexigator, can you point me to the talk page discussion about this particular block of content being unneeded lesser quotes? I agree that the last paragraph should be deleted, since it duplicates information above, so is redundant. I agree with the deletion of the other content from the definition section, because it is not more appropriate for criticism section. Perhaps instead of deleting it from the article entirely, it should be moved to the criticism section. FloraWilde (talk) 12:27, 30 May 2015 (UTC)

02:01, 28 May 2015. User:Qexigator:Qexigator (talk) 13:38, 30 May 2015 (UTC)

@User"Qexagator - Your reply does not show up for some reason.[19]. Could you please rewrite it? FloraWilde (talk) 14:21, 30 May 2015 (UTC)

??? Qexigator (talk) 14:41, 30 May 2015 (UTC)

You left your signature but no message. — Jeraphine Gryphon ^(talk) 15:12, 30 May 2015 (UTC)

Q....point me to the talk page... A 02:01, 28 May 2015 above. Don't know about red Qexagator, but there is nothing to add from.... Qexigator (talk) 16:38, 30 May 2015 (UTC)

@User:Qexigator - Your replies don't make sense to me. You wrote "Trim away unneeded lesser quotes/cites as proposed by another ed. at Talk" as your edit summary when you deleted this block of content, here.[20]. Where is the talk page discussion where another editor suggested deleting this particular block or content? FloraWilde (talk) 23:25, 31 May 2015 (UTC)

That content should not be deleted, unless duplicated in the body (the lead is always duplication). Maybe moved or tweaked, but every single source should be preserved. They are significant opinions, and since there is no single definition or understanding of what AM really is, they are significant parts of the "sum total of human knowledge" which we are required to document. -- BullRangifer (talk) 00:50, 1 June 2015 (UTC)

First sentence - scientific method

The first sentence describes AM as not based on the scientific method. I think a better sentence would use a phrase like "not based on scientific evidence" instead. The sentence, as is, is clear enough to me, a scientist. However, saying something is based on evidence obtained using the scientific method is near-meaningless to 75% of the people that I interact with on a daily basis. Since this article is likely an entry-point to Wikipedia for some users, I think the first sentence should be in plainer English.

I am sure a lot of thought has gone into this sentence but I think it would improve the article if there were plainer wording.Vile-eight (talk) 08:00, 13 December 2014 (UTC)

The article has been edited so as to present the information in a way that would make clear, and, it is hoped (from the encyclopedically neutral point of view) unarguable, that the distinguishing feature between "mainstream" and other/"alternative" is precisely that mainstream is (per history section) based on (evidence gathered) using the scientific method pioneered in USA by Welch (after visiting Europe) and promoted by Flexner and now dominant in medical schools in USA and elsewhere. Other practices "put forward as having the healing effects of medicine" are based on a variety of other theories, teachings or traditions, whether or not any evidence of efficacy can be produced using what are currently recognised as "the scientific method". "Can there be any reasonable 'alternative'?" -Arnold S. Relman (1998)[21] --Qexigator (talk) 09:05, 13 December 2014 (UTC)

I agree that it is a logically flawless statement. However, according to WP:Jargon "Every reasonable attempt should be made to ensure that material is presented in the most widely understandable manner possible." Furthmore, WP:EXPLAINLEAD states "In general, the lead should not assume that the reader is intimately familiar with the subject of the article. " Since the lack of scientific method, as you say, is the crux of the distinction for AM, then at this level, readers are not likely to be familiar with the implications of not following the scientific method. As such, the first sentence ought to describe what's distinct about AM, and should be clear to people have no understanding of the scientific method (notably, a full 80% of the American population, see http://www.nsf.gov/statistics/seind04/c7/c7s2.htm#note21) Vile-eight (talk) 23:09, 13 December 2014 (UTC)

I'm listening and intrigued. Clarity is always welcome. Can you propose a compromise which contains both aspects? -- Brangifer (talk) 23:12, 13 December 2014 (UTC)

"Alternative medicine is any practice that is put forward as having the healing effects of medicine, but is not based on scientific evidence.[1] " MIght not be perfect, but I think it's a start. Look forward to your feedback Vile-eight (talk) 23:44, 13 December 2014 (UTC)

The pipe link shows "scientific" but links to "scientific method": that obscures what is being said and thus diminishes clarity: the putative innocent reader is left to puzzle out what that is supposed to mean. May I offer this for consideration as an opening sentence, in a plain words version?

Alternative medicine is any practice that is put forward as having the healing effects of medicine , but is not based on evidence gathered using the scientific method. It consists of a wide range of health care practices, products and therapies The treatments are those that are not part of the conventional , science-based healthcare system.

But then, how would we go on and make some mention of the distinguishing feature that conventional is based on scientific method but alternative is not? Qexigator (talk) 00:11, 14 December 2014 (UTC)

I'll defer to you on your judgment of the pipelink (which I had thought was a widespread and accepted practice.) I'd submit that word 'scientific' inherently carries the notion of scientific method (it is in fact the primary definition in more than one dictionary) but since Scientific (perhaps wrongly) links to Science consider this: there is a page for scientific evidence which would work nicely. I think that the phrase 'scientific evidence' is a more intelligible concept than 'scientific method'. Alternatively, I would not be opposed to the terms 'scientific research' or 'scientific inquiry' which are more broadly synonymous with 'scientific method' than 'scientific evidence' yet, in my opinion, are more generally intelligible than 'scientific method'. I think that the edit you suggested, 1. deletes too much context and 2. has the problem you indicated in your last paragraph.Vile-eight (talk) 00:36, 14 December 2014 (UTC)

I don't see that inclusion of both ideas I was seeking. Evidence of effect can be arrived at by accident or by using the scientific method, so I see the "method" as being the biggest difference.

Whether it's taught in the "conventional , science-based healthcare system" is a totally different aspect of the subject, so let's not get into that in this thread.

Let's see if this will work:

• Alternative medicine is any practice that is put forward as having the healing effects of medicine, but that is not based on scientific evidence or use of the scientific method."

Brangifer (talk) 01:01, 14 December 2014 (UTC)

Great suggestion. I'm good with thisVile-eight (talk) 01:40, 14 December 2014 (UTC)

Let's see what Qexigator thinks. -- Brangifer (talk) 01:56, 14 December 2014 (UTC)

The more I read my proposal, the more I think that correct grammar requires the addition of "that" ("but that is not based on..."), so I have added it. -- Brangifer (talk) 07:17, 14 December 2014 (UTC)

A slightly longer, but even more accurate, version reads:

• Alternative medicine is any practice that is put forward as having the healing effects of medicine, but that is not backed by scientific evidence or evidence gathered using the scientific method."

This makes it clear that believers claim "evidence", but it is neither scientific nor discovered by using the scientific method. -- Brangifer (talk) 07:23, 14 December 2014 (UTC)

That seems about right, but "based on" may be more accurate than "backed". I'm hesitant to be more definite, mindful of the lengthy discussions about this paragraph which have occurred over the years. Qexigator (talk) 08:12, 14 December 2014 (UTC)

+(After further thought) Would this be acceptable? : Alternative medicine is any practice that is put forward as having the healing effects of medicine, but that is not based on or backed by scientific evidence or evidence gathered using the scientific method." Qexigator (talk) 15:59, 14 December 2014 (UTC)

That's even better! -- Brangifer (talk) 18:28, 14 December 2014 (UTC)

Alternative medicine is any practice that is put forward as having the healing effects of medicine, but that is not founded on scientific evidence or evidence gathered using the scientific method." perhaps?

Otherwise I'd go with based on or backed by, not both. I like backed for the simplicity but based for the precision Vile-eight (talk) 19:50, 14 December 2014 (UTC)

Cautious yes, reading "founded on" as synonym for "based on". But if you had to spell it out, how would "scientific evidence" differ from "evidence gathered using the scientific method"? Qexigator (talk) 20:29, 14 December 2014 (UTC)

Good point. So, are you proposing that the extra verbiage is unnecessary? For whom? For professionals or the public? I suspect that the public needs extra clarification, but are we going too far? Where is the middle ground? -- Brangifer (talk) 21:08, 14 December 2014 (UTC)

My question is, whether in this context, "scientific evidence" is meant to be distinct from "evidence gathered using the scientific method", and 1_if so/ or 2_if not so, is that a good way of letting the reader know? It may be that if they are practically synonymous here, it does no harm, and may do some good, to have them both as in the above version. But my feeling is this sentence must be as robust as possible, and effectively unarguable and beyond quibble (as mentioned above). Having reworded the article's current version thus far, it may be more effective simply to put: Alternative medicine is any practice that is put forward as having the healing effects of medicine, but that is not founded on scientific evidence or evidence gathered using the scientific method. If there is more to say, let that be added in another sentence. Perhaps, adding to the final sentence of the paragraph, to read: The treatments are those that are not part of the conventional, science-based healthcare system <insert> and are not backed by scientific evidence</insert>. Qexigator (talk) 22:08, 14 December 2014 (UTC)

That sounds good to me. -- Brangifer (talk) 02:05, 15 December 2014 (UTC)

Proposed revision, first paragraph

As above, will the followiing revision be acceptable, using "founded on" instead of "based on" in the first sentence, and adding "not backed by scientific evidence" at the end of the last sentence, of the first paragraph (citations and middle sentences unchanged, so not put in below)?

• first sentence Alternative medicine is any practice that is put forward as having the healing effects of medicine, but that is not based <insert>founded</insert> on evidence gathered using the scientific method. ....
• last sentence ... The treatments are those that are not part of the conventional, science-based healthcare system <insert> and are not backed by scientific evidence</insert>.

Qexigator (talk) 16:27, 16 December 2014 (UTC)

That still looks good. Try it and let's see how it looks. It just might fly. -- Brangifer (talk) 08:19, 17 December 2014 (UTC)

done. Qexigator (talk) 09:03, 17 December 2014 (UTC)

Looks good. Thanks. -- Brangifer (talk) 15:32, 17 December 2014 (UTC)

The constructive work on the first paragraph this tendentious topic is really heartening (in contrast to the many flame wars on other Wikipedia talk pages). I have one pedantic objection. The sentence says AM is "any practice...." Practicing law is a practice as are any number of other activities. I suppose our purported every-woman reader will automatically carry over the "medicine" from the first part of the sentence to use in the form of "medical" or "healing" etc., so for practical purposes the lack of a modifier is not detrimental. Kdammers (talk) 01:36, 18 January 2015 (UTC)

Agree - It's 4 months since Qexigator's proposal appeared to have consensus (mostly WP:Silence consensus), as there were no objections. But I don't see Qexigator's proposed added wording in the last sentence - "and are not backed by scientific evidence" in the article. I am adding it in. FloraWilde (talk) 09:34, 30 May 2015 (UTC)

It was done as said above. Don't jump to hasty conclusions. Qexigator (talk) 13:30, 30 May 2015 (UTC)

I was talking about Qexigators good suggestion for the first paragraph last sentence: "<insert> and are not backed by scientific evidence</insert>" above. I agree with BullRangifer that it looks good. I am adding it in by consensus. FloraWilde (talk) 14:42, 1 June 2015 (UTC)

Is there a typo or something missing in this sentence?

I can't figure out what the second means in this - "[alt med] is "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine." For conventional medical practitioners, it does not necessarily follow that either it or its practitioners would no longer be considered alternative." Why would anyone thing that it necessarily follows that alt med or alt med practitioners would no longer be considered alternative from this definition? Am I missing something, or is there a typo or something missing in this sentence? FloraWilde (talk) 02:49, 1 June 2015 (UTC)

That paragraph originally read:

One common feature of all definitions of alternative medicine is its designation as "other than" conventional medicine.[19] For example, the widely referenced [20][21] descriptive definition of complementary and alternative medicine devised by the US National Center for Complementary and Altenative Medicine (NCCAM) of the National Institutes of Health (NIH), states that it is "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."[22] This definition has been criticized as, if an alternative therapy, both effective and safe, is adopted by conventional medical practitioners, it does not necessarily follow that either it or its practitioners would no longer be considered alternative.[n 3]

FiachraByrne (talk) 12:51, 1 June 2015 (UTC)

Your original sentence accurately reflects what was in the source. But the source uses flawed logic, and is not RS. NIH is a biomedical institute, so when they write "conventional medicine", they mean "biomedicine", i.e., medicine that applies principals of biology, biochemistry, physiology, and other natural-sciences, to clinical practice. Those principals include gathering evidence using the scientific method, and principals already established by those natural science fields using scientific methods. So the NIH definition is essentially the same as Harrison, NEJM, and NSF, as would be expected. The source criticizing this definition is a promoter of spirituality in medicine, who self describes as "currently providing leadership in an initiative to establish a center on Spirituality and Health" at a major biomedical school.[22] The source has repeatedly published and posted promotions for adding Christian prayer, etc., to add to medical practice. If a traditional medicine practitioner prescribes chewing some fruit capsule for pain, and it is found that juice in that fruit capsule has chemicals with strong analgesic effects that are delivered in sufficient amounts by chewing the capsule to be very effective, and MD's across the country start prescribing the chewing of this capsule, then the general practice of the herbalist is still alt med, but the particular practice of prescribing the capsule-chewing for pain is not. The source is wrong since it does follow that the practice of prescribing the capsule chewing for pain would no longer be alt med. A real-life example is that bone-setting is practiced by ayurvedic medicine. Bone-setting is not alt med, ayurvedic medicine is. There are a number of quality sources on such errors in reasoning by alt med promoters, many of which are already in the article (sourcing other content).

It is true that many definitions are "other than biomedicine", but this has the same meaning as "what has not been shown effective in scientific tests and does not originate in natural sciences that are established using science." It is essentially the same as what is already in the article. It is UNDUE to add criticism of NIH by a paid promoter of putting religion back in medical practice, especially criticism that uses flawed logic to conclude that NIH is saying something that it is not saying. FloraWilde (talk) 14:36, 1 June 2015 (UTC)

The source for the sentence was the IOM report. As I've outlined above, I disagree with your opinion that this source is not RS for this content. Reports from the IOM are indeed classified as RS according to the WP:MEDRS guideline. It might be beneficial to take it to relevant noticeboard if its inclusion is a continuing issue. FiachraByrne (talk) 15:30, 1 June 2015 (UTC)

1. Where does the committee report to IOM say "all" definitions of alternative medicine include that it is "other than conventional medicine"? It says this is central to "the" definition, but it can only be talking about its own definition, since this is not central to, or even in, the NSF definition.

2. This is a report from a committee to the IOM, with a purpose being to represent salient alt med perspectives and to increase CAM usage, which the IOM then published with those caveats in the report. This is not MEDRS for representing perspectives of the biomedical community. If the IOM chooses a committee to define alt med from the perspective of homeopaths and voodoo practitioners, and chose all prominent homeopaths and voodoo practitioners for the committee, and the IOM published the report, saying this is a report "from the" IOM would be misleading, and the report would not be MEDRS. FloraWilde (talk) 17:32, 1 June 2015 (UTC)

Hi FloraWilde.

Re your first point, I've previously provided my reasoning for this here [23]. It's obviously open to dispute but I think it's reasonable to infer that the authors are characterising the range of definitions in the discussion that follows. Wieland (2011), I think, is interesting on this point:

CAM therapies have also been the focus of randomized controlled trials and systematic reviews, and some authorities have suggested distinguishing between unproven versus proven treatments, rather than conventional versus unconventional therapies.5 Despite this increased mainstream openness to and acceptance of CAM, there is a shared sense among practitioners, researchers and consumers that there remains a group of therapies that are in some sense outside the mainstream medical model, and that these therapies are appropriate to group together under the CAM label.

I think it's interesting that here the distinction between medicine and non-medicine - rather than, if you like, conventional medicine and CAM, is contextualised in an integration model (if given CAM therapies can establish scientific validity/therapeutic effectiveness). There are criticisms of the applicability of this distinction in arriving at a definition of CAM (specifically, that 'conventional' medical procedures, if they lack scientific validity, might be seen as bad practice (or not) but rarely as CAM (even given example of humoral medicine which you provide above). Personally, while not in the lead or anywhere like that, I do think that criticism should appear somewhere in the article.

On the second point, as previously stated I think the IOM Report meets WP:MEDRS criteria for the points made.

Anyway, I think I'm done here for the next while but you can ping me if there are any queries about or spot any anomalies in the little section that I wrote and I'll try and address them. FiachraByrne (talk) 09:46, 2 June 2015 (UTC)

Chiropractic in Switzerland

I am not sure if this is the correct location to place this comment, but it seems relevant to this discussion. If the article is going to speak of exceptions to the Alt Med status of chiropractic then editors might also want to look at Switzerland.

• "Switzerland is in a unique position within the chiropractic profession worldwide, being the only country where chiropractic is one of the 5 government recognized medical professions (medicine, dentistry, veterinary medicine, pharmacology and chiropractic). Since 2008, Switzerland has the first chiropractic program that is part of a faculty of medicine.4"[24]

70.65.253.158 (talk) 18:35, 1 June 2015 (UTC)

I think it's pretty obvious that it's not considered alternative there, even if it is elsewhere. -- BullRangifer (talk) 03:10, 2 June 2015 (UTC)

Agreed. Not sure it's necessary to add it though. A couple of examples should suffice to make the point. FiachraByrne (talk) 14:18, 2 June 2015 (UTC)

Is osteopathic medicine an alternative medicine or integrative medicine?

Our article says, "osteopathic medicine is no longer thought of as an alternative therapy in the United States". Osteopathic medicine without the theory or practice of osteopathic manipulative medicine (OMM), is identical with biological medicine. But OMM theory, and OMM practice, is alternative medicine. What happened is that less and less osteopaths are practicing OMM (about 50% now use it on less than 5% of their patients[25]), and it is not clear if any significant number diagnose under the theory of OMM. So there was not a change of thinking in the United States, as our article says. Since the point of the example is that alternative medicine somehow morphs into biomedicine in the thinking in the US, this example should be removed. FloraWilde (talk) 23:21, 31 May 2015 (UTC)

You're right. Osteopathy morphed into modern osteopathic medicine by rejecting its pseudoscientific and vitalistic roots. (By contrast, chiropractic has never officially rejected vertebral subluxation as the basis of the profession.) Because the profession changed, it became accepted, and laws reflected that change. Its acceptance was not based on the public or physicians gradually accepting quackery as good. Frankly, the public is oblivious to these issues. -- BullRangifer (talk) 23:39, 31 May 2015 (UTC)

Is 'oteopathic medicine' a mainstream medical speciality in any country other than in the US? FiachraByrne (talk) 00:00, 1 June 2015 (UTC)

Osteopathy exists elsewhere as an alternative therapy, but it's not anything like the American DO profession. -- BullRangifer (talk) 00:12, 1 June 2015 (UTC)

Our article makes it look like it was US opinions on OMM as alt med that changed, rather than that the alt med changed. FloraWilde (talk) 00:18, 1 June 2015 (UTC)

Why is osteopathic medicine exclusive to the US? FiachraByrne (talk) 00:32, 1 June 2015 (UTC)

Because it's a formalized medical education, pretty much on a par with "allopathic" medicine (MD), and laws have made them equal in status. -- BullRangifer (talk) 00:42, 1 June 2015 (UTC)

I'm not sure that really addresses the question. FiachraByrne (talk) 01:20, 1 June 2015 (UTC)

Also, could you clarify for me if Osteopathic physicians in the US typically engage in osteopathic manipulation? FiachraByrne (talk) 01:40, 1 June 2015 (UTC)

@FiachraByrne - I linked to the statistics on usage of OMM. (I presume it is usage in the US since the journal was of American colleges: Academic Medicine, Journal of the Association of American Medical Colleges - "Over 50% of the responding osteopathic physicians used OMT on less than 5% of their patients". (I only have access to the abstract, but implicit would be that 50% use it on more than 5%, not less than 5%.)

Yeah, sorry, I should have recalled that. More recent study available here. Not a great survey either. FiachraByrne (talk) 02:29, 1 June 2015 (UTC)

The reason for looking at osteopathic medicine in the US, not overall, is that the source explicitly says that osteopathic medicine is no longer considered alternative medicine in the US, to support its more general statement that there is a problem with the def of alt med in that what is considered alt med changes over time.

In the US, osteopaths are licensed to practice medicine. That does not mean osteopathy as a whole is not alt med in the US, if osteopathic manipulative medicine is given without biomedicine, or is not CAM when given with biomedicine. Osteopathy is alt med when OMM theory is used to base a diagnosis. The source appears to be either using the old defs of alt med sometimes used by some - "what is not taught" or "what is not licensed for practice of medicine". In any case, OMM is still considered alt med in the US, even though its practitioners are licensed to practice medicine. If an acupuncturist were to be required to learn biology, chemistry, physics, statistics, etc., then was trained in biomedicine in med school, and were then allowed to practice medicine, acupuncture would still be alt med. The source is either wrong and not RS on this, or is using different terminology than our article. I do not support this content of what counts as being alt med changing in the US as being in the article. FloraWilde (talk) 01:51, 1 June 2015 (UTC)

While I kind of get your point, I think your reasoning is a bit tortured - especially in regard to so-called 'new' and 'old' definitions (is there a source that designates alt med definitions in this way? perhaps the house of lords special committee 2010?). Can you cite a decent source that discusses the status of osteopathy in the US - as alt med or otherwise - in these terms? Regardless, I think the changing status of osteopathy - howsoever qualified - is absolutely relevant to the topic. I think the specificity of the status of 'osteopathic medicine' in the US is also telling. However, if you can find a good source, I'd personally welcome a clarifying statement on the status of osteopathy in US as it does seem to differ at least somewhat to osteopathy worldwide and this is, as indicated above, likely a product, in part, of the process of mainstreaming/professionalisation. FiachraByrne (talk) 02:29, 1 June 2015 (UTC)

(@FiachraByrne - Re sources re old discarded def (what is not taught at med school) and new definitions: “Eisenberg et al. defined alternative medicine (now often called complementary medicine) as ‘medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals.’ That is not a very satisfactory definition, especially since many alternative remedies have recently found their way into the medical mainstream. Medical schools teach alternative medicine, hospitals and health maintenance organizations offer it…” (Angell); "Until a decade ago or so, ‘complementary and alternative medicine’ could be defined as practices that are neither taught in medical schools nor reimbursed, but this definition is no longer workable, since medical students increasingly seek and receive some instruction about complementary health practices…” (Harrison)) FloraWilde (talk) 04:54, 1 June 2015 (UTC)

There is a reason we have two different articles, one for the AM version (Osteopathy), and one for the mainstream version (Osteopathic medicine / Doctor of Osteopathic Medicine (DO)). While it isn't always possible to prove when an exceptional DO uses quackish thinking (Joseph Mercola does), it is pretty certain that non-DO "osteopaths" consistently do so. They are more like naturopaths. Some other countries still have them, whereas most in the USA have become DOs. That's why the Osteopathy article is more international, while the DO article is mainly USA centered (possibly Canada too, IIRC). We wrestled with how to handle this matter and found that two articles was best. -- BullRangifer (talk) 03:27, 1 June 2015 (UTC)

(Thanks for clearing that Bullrangier.) The source says, "Other therapies may shift from being designated CAM to mainstream provision, such as osteopathy in the United States." From what BullRangifer says, osteopathy did not shift to not being considered alt med in the US. Rather, a DO degree was created, requiring identical biomedical training as an MD gets, and the DO can practice medicine. A DO is also trained to be an osteopath, but when that DO practice osteopathy, but that practice would still be considered alt med in the US, e.g. this MD says, "... learning osteopathic manipulation (OM) is the price they pay to obtain an otherwise standard medical education. I have yet to see OM offered by any of my DO colleagues. It may be they know better than to offer such a modality around me given my ranty propensity for all things SCAM. The literature would suggest that OM is left behind by most DOs upon graduation. DOs are not proud of their OM... OM, the small pseudoscientific aspect of DO medical school education, is a form of massage and manipulation invented in the 19th century with no basis in reality."[26]. So the source is wrong in its assertion and is not RS as to osteopathy. (I am not saying the author is not RS on other things in his/her article. But that author would have benefited by having BullRangifer as a peer reviewer as to osteopathy and DO in the US.) FloraWilde (talk) 04:25, 1 June 2015 (UTC)

Keep in mind that OMM is just a (series of) technique. It can be performed without any mumbo jumbo beliefs, just as a chiropractic "adjustment", without the subluxation mumbo jumbo, is just a spinal manipulation. These manipulative techniques can be performed by an MD, DO, DC, and PT, without any pseudoscientific mumbo jumbo, as basic manual therapy. I suspect that in the rare occasions that a DO does it, they are rarely doing it with any weird ideas, but purely as pain relief. Unlicensed osteopaths, and straight chiros, are doing it with all the pseudoscientific baggage which their original quackish professions gave them. -- BullRangifer (talk) 06:18, 1 June 2015 (UTC)

Yeah, FloraWilde you're correct re old (or, rather, now non-applicable) definition of alt med. Same point occurs in House of Lords Select Committee which I should have checked to confirm. The 'is not scientifically valid' definition is obviously pretty old too. AMA seem to have no longer defined osteopathy as a medical cult from 1961. NCCAM, among others, defines Osteopaths as conventional medical practitioners but defines OMT (without reference to 'mumbo jumbo') as a CAM therapy. Similarly with Cochrane. There's no doubt that the process of mainstreaming has moved osteopathy in the US closer and closer to conventional biomedicine in myriad ways. Yet, to some degree, osteopaths are still trained in OMT and associated 'mumbo jumbo' and US osteopath schools and institutions still attempt to maintain some distinction from conventional medicine with reference to certain holistic philosophies etc., or through selective invocation of Still's biography and teaching. Its continuing inclusion probably requires some clarifying comment but I'm of the opinion that this example is relevant to the potentially changing status of an alt therapy and alt practioners in a certain context and also indicates what changes in status are likely to entail (gradually shedding/sanitisation of 'alt' theories; greater incorporation of biomed principles, etc). FiachraByrne (talk) 16:08, 1 June 2015 (UTC)

Sorry if I'm stating the obvious, but this discussion highlights the fact that multiple definitions of alt-med exist. Today, OMM (in the hands of American DO's) is considered complementary or integrative or mainstream depending on whom you ask. By the EBM definition (Angell et. al.), it's pretty much CAM (AFAIK). By Harrison's, it's CAM because it has historic origins outside the mainstream. By IOM's definition, it's mainstream to the extent it's "intrinsic" to the mainstream (an intentionally fuzzy definition). Going just by sphere of usage, it's mainstream -- then again, some mainstream academic centers have CAM departments and/or offer CAM treatments, so.... --Middle 8 (t • c | privacy • COI) 22:21, 2 June 2015 (UTC)

Explanation of 2 (nitpicky) "dubious" tags

• I added a dubious tag to the part saying “all” defs have use of “other than” as a central part, because it is false. The NSF does not. But there is a problem with the NSF def having porous boundaries. Maybe all defs SHOULD use “other than” (on top of using “unproven or disproven”), but some sources (the NSF style defs) do not use “other than”.
• I added a dubious tag to “slight modification” because the committee report to IOM added “perceived by their users” to the definition, which is a MAJOR modification, not slight modification. Adding “perceived efficacy” to the "other than" definition is major improvement, not just a slight modification. A biomedical doctor may not believe a medication will be effective, but he/she will prescribe it anyway if it is established with rigorous testing and recommended by the AMA (if for no other reason than that they don’t want to get sued for professional negligence). If the condition improves, the biomed doctor may not perceive the improvement as resulting from the medication, and instead believe the condition would have resolved in the same way without the treatment, but they will still use it again, despite their disbelief and perception of ineffectiveness. This is in sharp contrast with an alt med practitioner, who may use some implausible method of diagnosis like a TCM doctor looking at the tongue for diagnosing a physical condition, because that practitioner believes in their TCM theory, even though it is not biologically plausible that the tongue would react in any way to that particular physical condition. The TCM practitioner likely perceives any improvement in the condition as arising from their treatment with acupuncture, whereas a biomed doctor would have said the condition resolved itself and the acupuncture could not possibly have been relevant. The “perceived” addition is a significant improvement, not a slight modification. FloraWilde (talk) 14:21, 3 June 2015 (UTC)

Second one is easy. Just change the qualification to "some" instead of "slight". Otherwise, you'll need a source to characterise the nature of the change. The clause just has to indicate that while they adopted the 1995 OAM definition, they introduced some changes.

First one I've already addressed, as best I can, previously on this page [27]. I'll rehash it here one more time and then leave the rest of you to form a consensus about it's inclusion or exclusion, although I will, if I'm able reply to any further queries. I'd also suggest that we discuss this issue only in this section and not elswehere on the page just for the sake of clarity.

So, there are two elements upon which its inclusion, I think, rests. The first is whether the statement is an accurate reflection of the source (IOM Report 2005). The second is whether the statement is so patently false that it should be excluded.

On page 14 of the 2005 IOM report, there is a paragraph which reads:

This report is about CAM, not about the quality of conventional medicine or the way in which it is delivered. However, as will be seen, central to the definition of CAM is that its constituent elements are “other than” conventional medicine. Therefore, an appreciation of both the strengths and the limitations of conventional medicine, especially as perceived by CAM users in the United States, is necessary context for development of conceptual models to guide public and private decision making about CAM research and practices.[Emphasis added.]

I take the statement, "as will be seen" as a clear foreshadowing of the general discussion of the definitions of CAM which follows on pages 16–20 of the IOM Report and as an identification of a characteristic common to all the definitions considered. This treatment of definitions in the IOM Report highlights the problems of defining CAM, opines that there is an absence of consistency in the definition of CAM, and evaluates all the major definitions of CAM in turn (descriptive, normative, stipulative, classificatory, etc.), finding each of them unsatisfactory to some degree. The authors, on page 19 of the IOM Report, opt to adopt as a 'working definition', a modified version of that devised at the 1995 NIH research methodology conference.

On the second element, I don't think it is erroneous to state that all significant definitions of CAM seek to distinguish it from 'conventional' medicine. All definitions seek to draw a boundary between CAM and conventional/biomedical/mainstream/legitimate medicine. They differ on how CAM is to be distinguished and under what criteria it is to be defined as other and, to some extent, they may differ on the definition of conventional/mainstream/legitimate medicine itself. Some definitions do so purely on the basis of effectiveness ('there is no alternative medicine only medicine that works') and may classify CAM as 'not medicine' or likewise, on the basis that CAM lacks scientific validity or that it may promote ideas about a mode of therapeutic action which contradict standard scientific principles. These biomedical definitions that find their point of distinction in the inherent properties of legitimate biomedicine and its inverse, share with those that look to regulatory frameworks, legal status, cultural prestige, social dominance, institutional support, political power, that they would introduce a line of division between the legitimate and illegitimate, the mainstream and marginal, the centre and fringe, and the orthodox and heterodox. I don't think that is actually controversial or that it even undermines the distinction between scientifically validated medicine and CAM. FiachraByrne (talk) 19:43, 3 June 2015 (UTC)

Is chiropractic considered alt med in Denmark?

Our article says, "chiropractic is not considered alternative in Denmark".

• 1. Who is doing the "considering"? Is it what biomedical doctors consider chiropractic to be? Is it what politicians voted chiropractic to be? This is not clear from our article. The source is pay-per-view. Can we get a better quote (and context quote) from the source from whoever did this edit? The the source used another source (i.e., if it is a tertiary source relying on a secondary source), can we get the quote and context quote from the original secondary source?
• 2. In Denmark, "Whenever patients consult a chiropractor without an allopathic physician's referral, the chiropractor must inform the patient's practitioner of the diagnosis and treatment, whether the practitioner is an allopathic physician or not." [28] This contradicts our article. Can the editor who made this edit provide more information to resolve this apparent contradiction? FloraWilde (talk) 23:18, 31 May 2015 (UTC)

"The menu of nonbiomedical approaches extends from traditional medical systems evolving in local settings or introduced into new settings, often with immigration, to modalities developed in the late nineteenth century, and a few of more recent origin. The diversity of modalities represents a wide spectrum of epistemologies and practices. In industrialized countries, these non-biomedical approaches are commonly designated as complementary and alternative medicine (CAM), yet their diversity makes it difficult to reach an agreed understanding of CAM. This is exacerbated by the shifting of definitional boundaries over time and across different locations. For example, in Denmark chiropractic is not considered to be CAM, and the local term denoting CAM refers to those therapies unavailable in the public health system, thus pointing to regulatory positions rather than knowledge practices. Other therapies may shift from being designated CAM to mainstream provision, such as osteopathy in the United States. Again others, depending on location and users, are considered indigenous medical knowledge systems, such as Ayurveda in India (see Lang and Jansen, this issue), while Ayurveda in the UK or Germany, for example, is likely to be perceived as CAM."

Nissen, N.; Manderson, L. (2013). "Researching Alternative and Complementary Therapies: Mapping the Field". Medical Anthropology. 32 (1): 1–7. doi:10.1080/01459740.2012.718016. PMID 23206171.

FiachraByrne (talk) 23:32, 31 May 2015 (UTC)

Yes, the change is purely based on legal status. Also, the Danish chiro education is not a traditional chiro education. The National Society for the Promotion of Chiropractic (Landsforeningen til Kiropraktikkens Fremme) literally paid the government an undisclosed huge amount to include a chiropractic education at the Odense campus of the University of Denmark. They share some classes with MD students, and end up with a Klinisk biomekanik (clinical biomechanic) Bachelors Degree.

Subluxation theory is not strongly emphasized in that education, but, unfortunately, as soon as they start their careers working with all the other chiros, who are educated in the USA and Canada with subluxation beliefs, they begin to believe them and practice like them. Regardless, they are now accepted as part of the health care system. The public is oblivious to the real issues involved, and only some MDs, and all scientific skeptics, show any concern about the Trojan horse effect they exert. -- BullRangifer (talk) 23:55, 31 May 2015 (UTC)

The reduced emphasis on non-biomedical modes of action (subluxation, etc.), if limited, is an expected part of mainstreaming. FiachraByrne (talk)

Exactly. -- BullRangifer (talk) 00:14, 1 June 2015 (UTC)

The article content is clearly supported by the source. The source does not cite its own sources. The source does not say who is doing the "considering". Its very unlikely an MD trained only in biology, then biomedicine, would find chiropractic and its subluxation theory basis anything other than alt medjust because they are Danish. (I vaguely recall recently seeing a movie in which some Belgians or Dutch were making exactly this kind of joke about the Danish.)

Given the 1992 law, it looks like the regulatory agencies consider it alt med, too. So the source appears not to be reliable as to what is the case in Denmark in re chiropractic. In this case, the content should be removed under RS.

Another possibility is that the source is RS on this, but the source used the old and discarded "what is not taught in a med school" definition for alt med. So if as BullRangifer says is correct, by paying the government to teach it in med school would make it not be alt med under that def. That is the kind of thing that mad that def be dropped. That def is no longer in use, and is overly criticized by most or all our more recent sources. So having this content, using a different def for alt med that is no longer in use, this misleads users. So the content should be dropped, since at best what is supported by the source would be that chiropractors paid the government to be taught in med school, or some such. (it's not unreasonable to teach all med students the theory under which chiropractic claims to work, so they can best advise their patients about it.) FloraWilde (talk) 01:10, 1 June 2015 (UTC)

To short-cut any extended discussion, does anyone wish to offer a superior source on the status of chiropractic in Denmark? FiachraByrne (talk) 01:47, 1 June 2015 (UTC)

I found two RS which document two facts (my translation):

1. It was politics, not evidence, which was behind the "recognition" of chiropractic:

"Politics - not facts - behind the endorsement of chiropractic" -- Politik – ikke fakta – bag blåstempling af kiropraktik

2. Chiropractic isn't considered "alternative" in Denmark, at least not officially:

"Views of alternative treatment vary from country to country. Chiropractic was covered by public health insurance in 1978 after decades of struggle between Danish chiropractors and medical professionals. In 1992 the government introduced authorization for Danish chiropractors. But in the US, for instance, chiropractic is still perceived as an alternative treatment." -- Brugere af alternativ behandling: Det kan ikke skade at prøve

Danish is my daily language. -- BullRangifer (talk) 03:16, 1 June 2015 (UTC)

@User:BullRangifer - 1. Recognition of chiropractic is not a declaration that it is not alt med. 2. Your source cites the same 1992 law I cited above, with a different source. "Authorization for Danish chiropractors" is not a declaration that it is not alt med. Given the language of the 1992 authorization, that they have to clear anything with a biomedical doctor, this would seem to argue that it is still considered alt med. FloraWilde (talk) 04:53, 1 June 2015 (UTC)

The second source does make it clear that Danish authorization changed the perception, in contrast to the perception in the USA, where it is still an independent, competitive, alternative medicine profession. Denmark has only one chiropractic school, and it's part of the University of Denmark, so it's "in the warm". That they have to clear their treatment with an MD is no different than for PTs in Denmark and the USA, and Physical Therapy has never been alt med in either country, since MDs created the PT profession to be their assistants. It's basically saying that chiros in Denmark, and PTs in Denmark and the USA, work under MDs. Even though some MDs would send me patients without even writing a diagnosis on the referral, as required by law, I would still contact the referring MD, tell them my findings and my differential diagnostic considerations, and they'd OK my treatment plan, which I would write on the referral, with signed annotation. That way I covered my ass. (They'd just tell the patient "Go to PT XNXNXN and he'll figure out what's wrong with you. That's how much they trusted my skills. I'd get referrals from physicians I didn't know from an hour's drive away, and the patients would drive that far to get treatment. Word of mouth is still the best advertising.) -- BullRangifer (talk) 06:10, 1 June 2015 (UTC)

@BullRangifer -- Aside: Agree re word of mouth; unfortunately if I were to say the same thing about my experiences as an L.Ac., it would be dismissed as mere testimonials, notoriously unreliable, etc. So it goes. --Middle 8 (t • c | privacy • COI) 05:34, 4 June 2015 (UTC)

@User:FiachraByrne, I don't know sources re Denmark other than the source on the 1992 law condemning chiropractic to be alt med being scrutinized by a biomedical doctor. But I can make a better statement of my problem with that using this source in general.

a. The source says, "The menu of nonbiomedical approaches extends from..." Then it describes a variety of alternative medicine practices. So the source is implicitly defining alt med as claims to heal that are not biomedicine, i.e., is not consistent with biology, physiology, biochemistry, and other natural science, or has not been tested using scientific methods. (Incidentally, I like this definition better than the NSF def, since it allows for practices implied by reasoning from biology, physiology, or biochemistry, even if they have not been rigorously tested.)

b. Then the source says, "This is exacerbated by the shifting of definitional boundaries over time and across different locations." Since the source implicitly defines alt med as what is not biomed, that would mean the source is claiming that the definition of "non-biomedicine" is shifting over time and location, which implies the definition of biomedicine is shifting over time and location. The examples cited to demonstrate this shift in the definition of biomedicine is that both Denmark and the US recently shifted its definition of biomedicine.

c. But the US and Denmark did not shift the definition of biomedicine as to acceptance of OMM theory. The US created a DO degree with the same training as given to MDs, plus training in OMM. Osteopaths without DOs are still not allowed to practice medicine, since OMM is alt med in the US. And when a DO practices OMM (which is apparently rare, they are considered to be practicing alt med in the US. FloraWilde (talk) 04:53, 1 June 2015 (UTC)

d. So the source is making logically flawed conclusions from the examples it uses as data for its conclusions. FloraWilde (talk) 04:53, 1 June 2015 (UTC)

Thanks BullRangifer, that's very informative.

FloraWilde, it's the local definition of 'chiropractic' as CAM or not which is relevant in this context. The source is actually pretty clear on this point.

I don't have a lot of time to devote to this but I can offer a further two sources [free-to-view, full-text] which support the contention that chiropractic is not typically regarded as CAM/alt med in Denmark.

The first is: Baarts, C.; Pedersen, I. K. (2009). "Derivative benefits: Exploring the body through complementary and alternative medicine". Sociology of Health & Illness. 31 (5): 719. doi:10.1111/j.1467-9566.2009.01163.x. [29]. It's a Danish study on users' motives for opting for CAM therapies. It offers this definition of CAM: 'In Denmark CAM treatments are not officially recognised as legitimate forms of medical treatment. CAM as defined in this study thus involves health care practices that lie outsidethe officially subsidised health care services. We define CAM as therapies that go beyond the treatments offered by the state-financed health system and as such are not under thecontrol of the Danish National Health Board.'

An explanatory footnote then states: '...chiropractic treatment is recognised by the official Danish health caresystem and integrated into publicly subsidised health care practices.'

The second source is: Hanssen, B.; Grimsgaard, S.; Launsø, L.; Fønnebø, V.; Falkenberg, T.; Rasmussen, N. K. (2005). "Use of complementary and alternative medicine in the scandinavian countries". Scandinavian Journal of Primary Health Care. 23 (1): 57–62. doi:10.1080/02813430510018419. PMID 16025876. [30]

This states that, for the purposes of their survey, 'Chiropractic was defined as an alternative therapy in the Norwegian and Stockholm County surveys, but not in the Danish survey'.

FiachraByrne (talk) 12:22, 1 June 2015 (UTC)

It seems that alt med is inconsistently defined in Denmark. If the law requires chiropractors to report to someone when they don't have a allopathic physician's referral, then chiropractic cannot be allopathic medicine, so chiropractic is alt med. If the law then defines chiropractic not to be alt med, then under Danish law, chiropractic both is and is not alt med at the same time. FloraWilde (talk) 18:15, 1 June 2015 (UTC)

I think that's a bit of an OR stretched opinion. "Allopathy" is a pejorative created by homeopaths to ridicule MDs, and it has never been accurate for MDs. It doesn't even apply to everything or every profession within mainstream medicine. PTs in Denmark also work under MDs, but they are not "allopathic". They are simply neuromusculoskeletal specialists. There isn't a sharp dividing line, with MDs on one side, and everything not MD (allopaths) seen as alternative medicine. It's not that simple, so this speculation isn't really helpful. The sources show that in Denmark, chiropractors are part of the mainstream of health care, like it or not, and I've never liked it. In this case, the definition of alt med vs mainstream is defined strictly by legal status. -- BullRangifer (talk) 03:00, 2 June 2015 (UTC)

LeadSongDog's insertion of Image:Jan Steen's "The Quacksalver"

Jan Steen's "The Quacksalver", circa 1655.

I undid this edit by LeadSongDog, where he added the image at the right to the top of the article. There was no consensus on the wording for the image caption. I suggest the following wording: “LeadSongDog (in Abe Lincoln’s hat) holds up a tootsie-pop, declaring that FloraWIlde’s insertion of an oversized acupuncture needle to the back of the patient’s neck is no more effective, at curing edit warring, than insertion of the tootsie-pop in the patient/editor’s gaping mouth. BullRangifer tarandus is not depicted because he speaks Danish every day, and this is a Dutch painting (Americans, like me, always seem to get these two confused), and because he is busy grinding his big bull antlers to make more TCM medicine. FiachraByrne is on all fours at the center of the lower Middle 8th of the image, sniffing around for an explanation of the dubious tags placed on his edits[31]. Sunrise occurs after this image was taken, since the lighting indicates the sun is still just below the horizon. Qexigator is in the tower (as User:Lexigator) inventing a “health system, modalities, and practices and their accompanying theories and beliefs intrinsic to the dominant health system of our society or culture in our historical period”, which was later re-devised by expert panel at a conference hosted in 1995 by the US Office for Alternative Medicine (OAM), as a theoretical definition of "biomedicine". This definition of "biomedicine" has been widely adopted by CAM researchers, cited by official government bodies such as the UK Department of Health, attributed as the definition used by the Cochrane Collaboration, and, with slight modification, was preferred in the 2005 consensus report of the US Institute of Medicine, Complementary and Alternative Medicine in the United States, using wording from our article. FloraWilde (talk) 01:41, 2 June 2015 (UTC)

LMAO! Good work. -- BullRangifer (talk) 02:51, 2 June 2015 (UTC)

Well done, perhaps we do take ourselves too seriously too often. Adding the image was inspired by this review (see under "Reflections"). LeadSongDog come howl! 06:24, 2 June 2015 (UTC)

Autolycus, The Winter's Tale, painting by C. R. Leslie, educ. Philadelphia, apprenticed to a bookseller.

Not sure how I feel about being a dog ... but picture is apt. Looks to be, I think, theatrical depiction of variant of stone removal/cranial lithotomy operation (depiction probably allegorical rather than documentary; extremely unlikely such operations were undertaken at this period). To say someone had stones/rocks in their head was to call them an idiot or a fool. So picture represents folly (tethered to the chair), folly's removal (stone shown before crowd) and implies deception (palm trick which actor/quack relied upon to produce stone; implied, but not shown here) and the gullibility of the crowd. FiachraByrne (talk) 16:10, 2 June 2015 (UTC)

Actually, for English language Wikipedia, Shakespeare is a better source, illustrated by Leslie's Autolycus of The Winter's Tale. Who's who? Pick your own. Qexigator (talk) 06:47, 2 June 2015 (UTC)

Nice choice Qexigator. FiachraByrne (talk) 14:13, 2 June 2015 (UTC)

Unfortunately, in contrast to the previous image, Autolycus is only selling trinkets and such like. I don't know the story, but is there any indication that Autolycus dabbles in quackery and sale of folk remedies as well? -- BullRangifer (talk) 15:36, 2 June 2015 (UTC)

He's a charismatic conman. FiachraByrne (talk) 15:53, 2 June 2015 (UTC)

That he is, and the picture can be seen as of a certain genre, maybe Allegorical-metaphorical, Pastoral-metaphysical, as Polonius might have said. "In the first quarto of Hamlet, Polonius is named "Corambis". It has been suggested that this derives "crambe" or "crambo", derived from a Latin phrase meaning "reheated cabbage", implying "a boring old man" who spouts trite rehashed ideas." Not many people know that, but thanks to Wikipedia it is easily accessible to all. Qexigator (talk) 16:28, 2 June 2015 (UTC)

Qexigator talking about reheated cabbage made me hungry, so I used a microwave to reheat the leftover hot dog I got at a gas station convenience store. It had sour kraut (i.e., once-heated cabbage) on it, so the bun got soggy, but I ate it anyway. I was wondering what a TCM practitioner might be able to get me to "believe or perceive" about the positive health effects. Traditional "Chinese Medicine, considers cabbage to taste sweet, it has neither hot or cold characteristics... One ancient Traditional Chinese Medicine books called 'Ben Cao Shi Yi' records that cabbage clears the channels by removing toxins that may block the Qi and blood around the joints, strengthens and loosens joints."[32] You can be sure anything would have a sweet taste after a mouthful of the TCM brew depicted in our own alt med article. And while it may be true that cabbage has neither hot or cold characteristics, "reheated cabbage" is hot after it comes out of the microwave. Since acupuncture has some evidence because needling that nausea point on your hand is better than the sham test (whatever that was), and acupuncture is part of TCM, TCM therefore has some evidence. So it is biologically plausible that if you have tight joints, you should not reheat the cabbage. Too bad I did not apply for a research grant to test "the effects of reheated cabbage on joint tightness arising from blocked qi and blood flow" before they used up that last "$2.5 billion spent, no alternative cures found" - NBC News. FloraWilde (talk) 05:23, 3 June 2015 (UTC)

Landseer's painting commissioned by Isambard Kingdom Brunel, part of series of Shakespeare-themed works

The above is an instance of a new branch of Eng. lit., "ASS" (Alternative Shakespeare Studies) an acronym that's an ever present reminder of the great and entertaining comedy MND. Qexigator (talk) 06:29, 3 June 2015 (UTC)

+For an original source for "cabbages--and kings", see L.Carroll[33] Qexigator (talk) 05:36, 4 June 2015 (UTC)

Empty references

In the current version of the article [34] two footnotes are broken (footnotes 65 and 69). Their ref names are CAMUS and NationalCancerInstitute respectively. Could any give me the full ref details so I can fix these? Also, Harrison's Principles of Internal Medicine is currently cited twice in the article (latest edition of Harrison). Does anyone have the correct page numbers for these citations? Thanks. FiachraByrne (talk) 01:44, 3 June 2015 (UTC)

The Harrison cites use the quotes provided by User:Middle 8 in the section above, so he/she should know the page numbers (or URL link). CAMUS is the 2005 committee report to IOM, page 19. The NationalCancerInstitute ref came from when I restored this[35] deleted section as a whole, then added more terminology in. In that version, it refers to ref name=NationalCancerInstitute>"Complementary and Alternative Medicine in Cancer Treatment". National Vancer Institute. Retrieved 2012-12-11. {{cite web}}: Cite has empty unknown parameter: |deadurl= (help)/ref. Note that I used "assume good faith" in the restoration, assuming the sources supported the content in the WLU version. (It would be unlikely the sources were not just as carefully scrutinized then, as they are now, so it is also fair to "assume good sources for conent".) FloraWilde (talk) 02:51, 3 June 2015 (UTC)

I'll check the Harrison's; I have the 2015 electronic version. --Middle 8 (t • c | privacy • COI) 03:55, 3 June 2015 (UTC)

Thanks to you both. I'll amend the citations now and add pagination for Harrison as soon as Middle 8 posts them here. The IOM citation appears in shortened form in the article as 'CAM Committee 2005' (the full citation is included in the bibliography section if you click on shortened refs in footnotes) - is this the best shortened form for this ref? I guess a better alternative might be 'IOM Report 2005'? It's easy enough to change so any improved suggestions are most welcome. We seem to be using sfn or harvnb for books (the latter used for bundled citations) and a defined reflist for everything else. Not the simplest system but it cuts down on clutter in the text while allowing unobtrusive pagination to be added for books, etc. Is this system okay with everyone? FiachraByrne (talk) 09:27, 3 June 2015 (UTC)

I need Harrison page number for following quote:

The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine. Most of these practices are used together with conventional therapies and therefore have been called complementary to distinguish them from alternative practices, those used as a substitute for standard care. ... Until a decade ago or so, “complementary and alternative medicine” could be defined as practices that are neither taught in medical schools nor reimbursed, but this definition is no longer workable, since medical students increasingly seek and receive some instruction about complementary health practices, and some practices are reimbursed by third-party payers. Another definition, practices that lack an evidence base, is also not useful, since there is a growing body of research on some of these modalities, and some aspects of standard care do not have a strong evidence base

FiachraByrne (talk) 10:41, 3 June 2015 (UTC)

@ FiachraByrne, it's page 14e-1. The "e", I believe, refers to chapters that are in the electronic version only. The chapter title is "Complementary, Alternative, and Integrative Health Practices". I'll see if I can find where it needs to go in the article ... (update) OK, got it [36] --Middle 8 (t • c | privacy • COI) 05:59, 4 June 2015 (UTC) updated 13:34, 4 June 2015 (UTC)

Thanks again. Just to clarify, is it page 1 of chapter 14e? FiachraByrne (talk) 13:45, 4 June 2015 (UTC)

Do "all definitions" use "other than" and "conventional"?

A source (committee report to IOM) defines CAM as "...other than conventional medicine". The source says its definition uses "other than" as central to the definition - "central to the definition of CAM is that its constituent elements are 'other than' conventional medicine. "Central" to the NSF, NEJM, and Harrison definitions is scientific evidence or origins in biomedicine, not "other than". So the source could only be talking about its own definition in its declaration of what is central.

• 1. Our article says, "One common feature of all definitions of alternative medicine is its designation as "other than" conventional medicine". This content in our article is not supported by what is in the source. The sentence should be deleted as WP:OR.

*2. The source and its definition were moved higher up in the definitions section, even though the source had a majority purposely selected to represent salient CAM and integrative medicine, and a goal overtly stated as being to get patients to include CAM in their health care choices. I did not remove the redundancy below because I did not want to delete anyone's edits. FloraWilde (talk) 00:15, 1 June 2015 (UTC)

These changes would solve the problem: "One common feature of all some/many(?) definitions..." -- BullRangifer (talk) 00:19, 1 June 2015 (UTC)

I wrote that sentence. I didn't move it up 'higher in the definitions section'. Rather, I began with that source because it was the best source I could find - and I looked at many - giving a comprehensive overview of the various definitions of CAM. It discusses these definitions from pages 14 to 20, and finds them all lacking in various ways. For the purposes of the report, the authors settle on a variant of the unlovely NCCAM definition which I'm sure you're familiar with and which suits them in excluding any reference to scientific validity or therapeutic efficacy. The source states that 'as will be seen, central to the definition of CAM is that its constituent elements are "other than" conventional medicine' [emphasis added]. I read that statement (probably, it was some time ago) as indicating that their designation as other than conventional medicine was a common feature of the various unsatisfactory definitions of CAM that followed. Hence my statement, 'One common feature of all definitions of alternative medicine ...'. Synthesis might be a more apt accusation than original research but, personally, I think it's a justifiable summation of the source from pages 14-20. You obviously disagree but we won't fall out over it. Not that such an argument has much validity here, but it's also pretty self-evidently true that all definitions seek to differentiate CAM/alternative medicine from conventional/mainstream/biomedicine/scientific medicine/medicine (etc., etc.). They differ on the basis of that differentiation (e.g. scientific validity, professional marginality, etc.).

I'm curious as to what other information in the paragraph you now think is redundant?:FiachraByrne (talk) 01:18, 1 June 2015 (UTC)

@FiachraByrne - You should be curious, since what I wrote makes no sense at all. I made an error. Actually, I made two errors. First, there were two paragraphs where I put dubious tags, and I was thinking about the paragraph starting "An expert panel at a conference hosted...". My second error was thinking that paragraph had a redundant block quote because I just move the quote up. I was reading that paragraph in edit mode, not reading the article as it appears to users, and I failed to see that the block quote was embedded in a reference, and did not appear in the article body. So there is no redundancy. My error. I struck my comment. Sorry to waste your time here. FloraWilde (talk) 02:36, 1 June 2015 (UTC)

Re "the best source I could find" - When I first saw the name IOM on it, it appeared to me to be one of the best sources possible. I thought IOM issued the report as the view of its membership or leaders (top notch biomedical doctors, who likely loath alt med, but spend their time worrying about problems with biomed practices based on theory but not tested, statistics for publishing, etc. I noticed the report defined in terms of practitioner/patient "perception" of efficacy, which is a very CAM/integrative med perspective. So I decided to look up the committee membership. A majority had big financial interests in alt med. I then read the report more carefully, and noticed the committee was selected by IOM, not to represent the view of the medical community, but to represent salient alt med perspectives. Then I noticed it was a report "to" the IOM, not a report "of" the IOM. I read it even more carefully, and found one of the overtly stated goals of the committee was to increase patient use of CAM. FloraWilde (talk) 03:43, 1 June 2015 (UTC)

I don't think the above invalidates the IOM report as a reliable source for the content for which it is cited in this article. It was published by the National Academies Press. The report was commissioned by the IOM's US Board on Health Promotion and Disease Prevention. The project was approved by the Governing Board of the National Research Council. We are told that 'The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance'. You may disagree with how the IOM chose to populate that committee, but that's really neither here nor there. We are also told that 'This study was supported by [a contract] ... between the National Academy of Sciences and the Agency for Health Care Research and Quality, National Institutes of Health.' FiachraByrne (talk) 13:16, 1 June 2015 (UTC)

I agree that the committee report to IOM can and should be used for certain content, and its definition should be at a prominent place, but with appropriate qualifying language that it is from the perspective of a committee with a majority from salient alt med perspectives. It is RS as to statements about CAM perspectives on what they perceive themselves as doing and being. The report hit the nail on the head with "CAM includes such resources perceived by their users as associated with positive health outcomes."

Your suggestion to qualify the NSF/Angell def as being from the perspective of science/biomedicine was a very (very) good suggestion. It will automatically stop complaints from alt med POV editors who have a different take on what alt med is. I added similar qualifiers to the IOM committee def, which will similarly stop complaints from science-oriented editors who might otherwise gripe about replacing the expressions like "biomedicine" or "scientific methods and principals of established natural science" or with "practices and beliefs that are intrinsic to the dominant health system of a particular society or culture in a given historical period". (I am one of those potentially griping editors, so the qualifiers even shut me up from griping.)

I do not disagree with how the IOM chose the committee. Given a stated purpose being to include salient alt med positions, IOM is the best agency to select a committee to produce a report from the alt med perspective, and its majority was balanced by a good number of biomedical MDs. FloraWilde (talk) 17:06, 1 June 2015 (UTC)

FloraWilde, to be clear, that IOM report is a "consensus report", prepared by a committee for the IOM and specifically intended to represent the conclusions of the IOM.[37] It shouldn't have any qualifiers at all. Similarly, we can't give special place to Angell as speaking for science/biomedicine. Angell's a very good MEDRS. But the IOM is a much stronger one. It's probably the single best source we have -- it's unusual and valuable to get a statement reflecting the views of a scientific academy. Such sources are the best to use for WP's voice and can be trusted as representing scientific consensus (or in this case, their attempt to explain and distill the full range of views). --Middle 8 (t • c | privacy • COI) 05:25, 4 June 2015 (UTC) copyedit 13:27, 4 June 2015 (UTC)

“… to define them in terms of ‘otherness’ — that is, by what they are not … (as in… ‘not practised by conventional medicine’) — is arguably useless.” The rise and rise of complementary and alternative medicine: a sociological perspectiveIan D Coulter and Evan M WillisMed J Aust 2004; 180 (11): 587-589 FloraWilde (talk) 16:44, 2 June 2015 (UTC)

Yes many sources point out that it is problematic to do so for a range of reasons. All the definitions are engaged in some form of boundary-work and none have been deemed entirely adequate. FiachraByrne (talk) 17:10, 2 June 2015 (UTC)

This full quote of that source is “… to define them in terms of ‘otherness’ — that is, by what they are not … (as in… ‘not practised by conventional medicine’) — is arguably useless. We do not define allopathic medicine [ = biomedicine] by what it is not.” But it is not useless to say "other than allopathic (biomed) if you then define biomed in a positive way. "Alternative medicine is a diverse group of medical and health care systems, practices, and products that originate outside of biomedicine,[64] are not considered part of biomedicine,[4][65]:19 are not widely used by the biomedical healthcare professions,[66] and are not taught as skills practiced in biomedicine.[66]" uses the sources Middle 8 liked, IOM and Harrison, as well as BMA, followed by a sentence defining biomed from the wiki article on it. The sources were IOM (a biomed institute), Harrison (a biomed text), and the current "dominant orthodoxy" (or whatever similar words were used) is biomed, and BMA was using what was taught at the time and place of its def, i.e., biomed, so all sources were defining alt med as "other than biomed" in the manner cited. Your previous scholarship and discussion of quotes from these sources was very helpful in getting context to winnow down to a single sentence. FloraWilde (talk) 17:21, 2 June 2015 (UTC)

I think we're getting close with the all-encompassing proposals below -- nicely done. That said, FWIW, it would grossly violate NPOV to identify Angell as being particularly science-based (compared to IOM or Harrison's). And it's absurd to say IOM is an RS for alt-med POV but not mainstream.[38] And personal attacks have no place here ("It will automatically stop..."). Just saying. But the below is looking good. --Middle 8 (t • c | privacy • COI) 22:48, 2 June 2015 (UTC)

FloraWilde, I'm not much of a scholar, but thank you for the kind words. I've commented on your suggested text below. FiachraByrne (talk) 00:37, 3 June 2015 (UTC)

All-encompassing definition

This may be a slight change of subject, but keep in mind that since, as sources clearly state, it is not possible to find one precise definition of alternative medicine in any one RS, we shouldn't try to settle on one, but should include several different types of definitions, as we find them in various RS. They all contain some elements of truth, and none of them apply to every aspect of the subject. All of these definitions should be in the body of the article.

For the purposes of our lead, we can then follow the rules for lead content, which is our own summation of the content in the body. That means we create our own all-encompassing definition, which is a faithful synthesis of what's in all those definitions. It's okay if they are partially conflicted. It may take two to three sentences to do that, but it can be done, and they should be in the first paragraph, just as the definitions should be in the first section(s) of the article. I think the article has previously tried to do that. That's what makes Wikipedia better than any other encyclopedia. Nowhere else will you find such good descriptions of a subject, because our definitions are not bound to one dictionary, but rather to the sum total of human knowledge as found in RS, and reality is often messy and conflicted. -- BullRangifer (talk) 06:35, 1 June 2015 (UTC)

We should not treat this article different than other Wiki articles. There are thousands of scientifically RS about problems with a precise definitions of "species" or of "organism". The problem with defining species and organism are far more significant and deep than defining alt med. There are hundreds of subtly different definitions of "species" or "organism", all with RS. If an editor with a creationist POV were allowed to water down those articles with problems about the definition "boundaries" being fuzzy, as has been done here, then those articles would have massive definitions sections with WP:UNDUE size compared to the more informative sections. We are giving WP:Undue size to our definitions section. This is a disservice to users of the encyclopedia.

We repeat what is essentially the same definition over and over and over and over. The NSF definition and Angell definition are that alt med is what does not arise from science and has not been established using established natural science and scientific methods. I.e., it claims to heal but is not founded on science, as biomedicine is. The Harrison definition (put in prominently at the top, at the request of Middle 8 and FiachreByrn saying he agreed with Middle 8), says "group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine"." The context (not provided), is that Harrison is a biomedicinetext. So "mainstream" refers to biomedicine. Biomedicine is medicine that applies principals of biology, biochemistry, physiology, and other natural-science principles to clinical practice. Those principals include gathering evidence using the scientific method, and principals already established by those natural science fields. So the Harrison definition is basically the same as NSF and NEJM.

Then this is repeated with slightly different words over and over, without context for a reader to understand that the different wording is saying essentially the same thing. We next have "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine" by the National Institutes of Health (NIH). The context (not provided) is that NIH is a biomedical research facility. So in this context "conventional medicine" refers to biomedicine. The article's next paragraph has ""those forms of treatment which are not widely used by the conventional healthcare professions, and the skills of which are not taught as part of the undergraduate curriculum of conventional medical and paramedical healthcare courses." The context (not stated) is that when that definition was proposed, what was widely used and the undergraduate curriculum was biomedicine. The article's next paragraph has ""interventions neither taught widely in medical schools nor generally available in US hospitals". The context (not stated) is that at the time that definition was proposed, what was widely taught in med schools and gernerally available at US hospitals was biomedicine. The article's next paragraph has ""a broad domain of healing resources ... other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period." The context (not given) is that the politically dominant health system in the English Wikipedia societies , and in the time of now, is biomedicine. These definitions with slightly different wording, but no context for a user to see that the meaning is essentially the same as already said, are not needed, and give WP:Undue space to the definitions section. FloraWilde (talk) 09:18, 1 June 2015 (UTC)

Given the above discussion (and past discussions), I'm inclined to agree with ... give WP:Undue space to the definitions section, unless others can refute. But let me stress, multiple definitions which on inspection come to essentially the same thing are unneeded, while the explanatory discussion as in the present version seems about right (subject always to c/e tweaks). Qexigator (talk) 14:46, 1 June 2015 (UTC)

I agree that duplication of essentially identical concepts is not necessary. In reality they can all be boiled down to just a few basic concepts. Those concepts can be included, with multiple refs identifying where they are dealt with in more detail, and that way we keep the sources, without cluttering up the article with long quotes from each source. (Tim Minchin's quote happens to sum up the scientific skeptic position, such as Angell, very well. ). -- BullRangifer (talk) 15:10, 1 June 2015 (UTC)

I agree with comments by Qexigator and BullRangifer. I summed up all the below-quoted definitions of Harrison, NIH, and BMA (which all essentially say the same thing), in one sentence: "Alternative medicine is a group of diverse medical and health care systems, practices, and products that originate outside of biomedicine,[60 - Harrison] are not considered part of biomedicine,[4- NIH] are not widely used by the biomedical healthcare professions,[61 - BMA] and are not taught as skills practiced in biomedicine.[61]" FloraWilde (talk) 16:14, 1 June 2015 (UTC)

Is this "all encompassing"? It used all 16 of the suggested best sources (IOM, Harrison, NSF, NEJM (Angell), NIH (NCCAM), Brit Med Ass (BMA), NY Acad of Sci, Canadian Med Ass, Nature, Nature Medicine, Am Psych Ass, Journ Ass of Med Colleges, Med Journ of Australia, WebMD, NCCIH, and even Carl Sagan) in a single self-consistent sentence - ""Alternative medicine" is a loosely defined set of products, practices, and theories that are believed[1] or perceived[2]:19 by their users to have the healing effects of medicine, but whose effectiveness has not been clearly established using scientific methods, whose theory and practice is not part of biomedicine, and some of whose theories or practices may be directly contradicted by scientific evidence or scientific principles used in biomedicine." FloraWilde (talk) 17:01, 2 June 2015 (UTC)

Both of those look good (i.e. FloraWilde at 16:14 and 17:01, 1 June), but don't we need "and/or" instead of "and"? That neatly highlights both the overlaps and the distinctions. (Some of the RS clearly say the definitions differ.) And we need origins, cf. Harrisons .... and we need IOM's point about mainstream being culturally determined ... so, how about this:

""Alternative medicine" is a loosely defined set of products, practices, and theories that are believed[1] or perceived[2]:19 by their users to have the healing effects of medicine, but whose effectiveness has not been clearly established using scientific methods, and/or whose theory and practice are not (or did not originate as) part of the dominant medical system in a given culture in a given historical period (e.g. biomedicine today), and/or some of whose theories or practices may be directly contradicted by scientific evidence or scientific principles used in biomedicine."

What think? Unsure if struck part is needed or not... --Middle 8 (t • c | privacy • COI) tweak to add "in a given historical period". 23:08, 2 June 2015 (UTC)

I haven't checked the sources but, for what it's worth, I think FloraWilde's 2nd version (2 June 17.01) is comprehensive, NPOV and reasonably succinct. I appreciate the distinctions and qualifications that Middle 8 has suggested, but I think that they would freight this already complex sentence with too much weight and make it essentially unreadable. On a small grammatical point, it should read, I think, "whose theory and practice are" rather than "is". Possibly you could shorten "the healing effects of medicine" simply to "healing effects". But this last suggestion is not in any way necessary in my view. FiachraByrne (talk) 00:30, 3 June 2015 (UTC)

I concur with FiachraByrne. I think that FloraWilde's 2nd version (2 June 17.01) is excellent. Great work! -- BullRangifer (talk) 02:31, 3 June 2015 (UTC)

(e/c with BullRangifer) Yeah, mine was clunky, and agree, most of my tweaks can be fleshed out elsewhere. But I think "or" is actually pretty key, logically and per WP:STICKTOSOURCE. We can assume the "and" but need the OR, otherwise we restrict the definition more than our sources do. Adding "or's" and doing the grammatical fix, FloraWilde's 2nd version (2 June 17.01) becomes (emphasis mine):

""Alternative medicine" is a loosely defined set of products, practices, and theories that are believed[1] or perceived[2]:19 by their users to have the healing effects of medicine, but whose effectiveness has not been clearly established using scientific methods, or whose theory and practice is not part of biomedicine, or some of whose theories or practices may be directly contradicted by scientific evidence or scientific principles used in biomedicine."

Some of that might be pruneable, e.g. the repeated "theor(y/ies) and practice(s)", and the last few words (perhaps just "scientific principles", since we cover evidence already, and scientific principles inherently include reliance on evidence). --Middle 8 (t • c | privacy • COI) 02:41, 3 June 2015 (UTC) emphasis added 07:04, 3 June 2015 (UTC)

IOW, we need "or" punctuating the various definitions because a weed can be unsightly or smelly or instrusive ... we wouldn't restrict the definition by saying it's all three at once, right? --Middle 8 (t • c | privacy • COI) 07:04, 3 June 2015 (UTC)

Agree on the inclusion of "or" as argued by Middle 8 above. It's a more accurate rendering of the sources. FiachraByrne (talk) 19:53, 3 June 2015 (UTC)

I now agree on replacing "and" with "or", and made the replacement. "A, or B, or C, or D" is logically equivalent to "A, B, C, or D". The latter is preferred in most English language manuals of style. Does anyone object to using the latter style? FloraWilde (talk) 15:46, 4 June 2015 (UTC)

Sorry for the stupid question. Per talk at WP:MOS - "It's one of those things that's so obvious that we don't have a rule about it", so I used the more simple style.[39] FloraWilde (talk) 18:23, 4 June 2015 (UTC)

Totally agree... as long as the "or" is implied in context, it's better prose to omit it. --Middle 8 (t • c | privacy • COI) 00:19, 5 June 2015 (UTC)

“Other than biomed” AND “unproven or disproven” AND “belief or perception”; meaning as denotation;

Resolved

• Otherwise reliable sources may contain errors, or have meanings determined by contexts that are lost by just lifting a sentence out and putting it in Wikipedia. To define alt med, we need all of “Other than biomed” AND “unproven or disproven” AND “belief or perception” for the following reasons:
• Using only “other than” as the only thing in a definition is not sufficient. A quote from a 1977 Science magazine article says, “The dominant model of disease today is biomedical…”[40] Science magazine is "one of the world's top scientific journals”. This article was cited by over 8,000 academic publications. (That’s a lot.) But the author (and subsequent authors citing the author) then goes on to propose models for “healing resources ... other than those intrinsic to the politically dominant health system”. What is proposed is the “biopsychosocial model”, an evidence-based model that satisfied the "other than" definition, but is not alt med. Similarly, an article in the Britich Journal of Medicine says, "The biomedical model of illness, which has dominated health care for the past century…" then goes on to discuss a model for “healing resources ... other than those intrinsic to the politically dominant health system”. But it is an evidence-based model, and has nothing at all to do with alt med. Although they satisfy some “broadened” definitions of alt med, these are science-based models, and are NOT considered alternative medicine. So it is not sufficient to define alt med in terms of “other than dominant health system”, “other than conventional medicine”, or even “other than biomedicine”. Those may be true statements ABOUT alt med, but they do not DEFINE it. The definition of alternative medicine needs the NSF et al part about “unproven or disproven by scientific methods or theories”, as an essential part of the def.
• Harrison finesses this by using “not having origins in standard medicine”, which is useless to a Wiki user without going on to explain what Harrison, a premier biomedicine text, means by “origins” and “standard medicine”. Harrison’s unstated context is that it is a premier biomedicine text, assuming the biomedical model and assuming its users are assuming a biomedical model, and assuming a target readership that is trained in scientific methods where “origins” means what arise from scientific methods. Describing these contexts add up to being the same thing as simply the NSF def (which is porous as a stand-alone def unless we add “other than biomed”, as Harrisin pointed out). So when using Harrison as a definition, we must also add “biomedicine” and language like “unproven or disproven”.
• As pointed out by RS, e.g., Harrison, since at least some “standard med” is scientifically unconfirmed (or even disconfirmed) by scientific evidence, a definition having only “unproven or disproven”, like top notch RS such as NSF, is not airtight (but is still usable) for a stand-alone definition of alt med. Harrison describes this as having porous boundaries. The definition must also add a contrast with healing methods arising from use of scientific methods.
• As demonstrated by the millions of alt med websites pushing what they (or their users) believe or perceive to work, and which is unproven or disproven and is other than biomed, when an English speaker uses “alt med” in a sentence, the sentence has at least some meaning in a “logical theory” of meaning based on reference or denotation. So saying there is no such thing as “alt med” is false, unless what is meant is that there is no proven alternative to science based medicine. FloraWilde (talk) 17:51, 3 June 2015 (UTC)

Please, FloraWilde, respect the spirit of tl;dr and try to keep your arguments concise. My reply in brief is: WP:STICKTOSOURCES. As pointed out above, Harrison's and IOM (yes, they are MEDRS, damned good ones) consider multiple definitions and find fault with some of them. Harrison's specifically says that the definition "practices that lack an evidence base" is insufficient. That puts them squarely in disagreement with Angell, Tim Minchin et. al.   Per "NPOV 101", we need to make clear to the reader that multiple definitions exist: A or B or C. A new, restrictive definition "A and B and C" is SYN, no matter how much special pleading to the contrary.

Meta-Comment: I'm annoyed by the suggestion that attempts to portray the full spectrum of RS definitions reflects an alt-med-centric motivation.^{2nd para} That's bullshit. If WP has reached the point where sources like IOM and Harrisons are considered POV simply because they may include the views of mainstream scientists interested in or sympathetic to CAM, then WP's gone off the deep end into its own fringe territory. A range of views on CAM exists in the mainstream: if it didn't the phrase "quackademic medicine" wouldn't exist. And often the "quacks" (e.g. academic medical centers) at least as weighty as the critics (e.g. science bloggers). Time to chill and respect NPOV (and quit shooting the messengers who cite good MEDRS some editors disagree with). --Middle 8 (t • c | privacy • COI) 00:11, 4 June 2015 (UTC) copyedit 00:42, 4 June 2015 (UTC)

For readability, the expansion of the first sentence to the ...or...or ...or version may be some disadvantage compared with the earlier simpler version,[41] but in terms of Miidle8's comment above ( 00:11, 4 June) it is not unacceptable, and, all told, may be preferable to alert the reader to the sort of thing that will be found in what follows, in the article's attempt to present the information in a more or less encyclopedic and npov fashion. Qexigator (talk) 05:41, 4 June 2015 (UTC)

Sources that cite multiple definitions as RS for all of them

Just one more thought: As long as a definition is important enough for a source like IOM or Harrison's to consider it seriously, it should be good enough for us to mention. Obviously the sources that they prefer will weigh more, but a source doesn't have to be IOM's favorite for it to be significant; their mentioning it provides enough weight. I think our nicely-evolving "all-encompassing definition" probably catches most of the extant definitions by now, but will check. --Middle 8 (t • c | privacy • COI) 13:25, 4 June 2015 (UTC)

New age, postmodernism, cultural relativism

The article lacks information on influence of the New Age movement (New_Age#Healing_and_alternative_therapies), postmodernism, and cultural relativism in the history section. FloraWilde (talk) 14:57, 5 June 2015 (UTC)

I expect reference to postmodernism and cultural relativism might be in more polemical pieces (although they may indeed be RS). Saks has a piece on the influence of the counter culture which is worth a read.

Saks, Mike (2002). "Medicine and the Counterculture". Companion Encyclopedia of Medicine in the Twentieth Century. London: Routledge. pp. 113–24. ISBN 9780415286039. {{cite book}}: Unknown parameter |editors= ignored (|editor= suggested) (help)

If you want a copy email me. FiachraByrne (talk) 15:09, 5 June 2015 (UTC)

There are about 300 Google Scholar results[42] and over 30,000 Google results[43] for "'Cultural relativism' AND 'alternative medicine'". Yet the expression does not appear in our article.

There are over 3,000 Google Scholar hits for "'alternative medicine' AND postmodernism"[44]. Our article does not contain the word at all.

There are about 40,000 results for a Google Scholar search of "'alternative medicine' AND 'cultural relativism'"[45]

There are about 40,000 results for a Google Scholar search of "'alternative medicine' AND 'new age'"[46] Until I added the expression as a synonym, it did not appear in our article.

These absences, and things said in the academic sources, would argue for viewing our article as having a POV and thereby being somewhat of a "polemical piece". FloraWilde (talk) 15:35, 5 June 2015 (UTC)

There are 5,380 Google Scholar results for "alternative medicine" and "cats" [47]

There are 520,000 Google results for "alternative medicine" and "cats" [48]

I'll begin drafting the section on alternative medicine and cats. You work on the above. FiachraByrne (talk) 15:36, 5 June 2015 (UTC)

The above is tongue in cheek, new age/counterculture and cultural change in the 1970s is relevant. 'Cultural relativism' is used, typically, in a polemical way. That's not necessarily an argument for non-inclusion of such sources that use the term (although I may not like them). Sources are not required to be neutral, after all. But our intent, I think, in representing the sources shouldn't be polemical. FiachraByrne (talk) 15:42, 5 June 2015 (UTC)

Should errors be repeated at Wiki because they occur in what is an otherwise RS?

(This is a partial repeat from a section above, which was not responded to.) A quote from a 1977 Science magazine article says, “The dominant model of disease today is biomedical…”[49] Science magazine is "one of the world's top scientific journals”. This article was cited by over 8,000 academic publications. (That’s a lot.) The author and subsequent authors citing the author, went on to propose the biopsychosocial model and treatments based on it. These treatments satisfy the OAM/Cochrane/IOM committee definition criteria for being CAM because they are “healing resources ... other than those intrinsic to the politically dominant health system”. But they are not CAM. Similarly, an article in the Britich Journal of Medicine says, "The biomedical model of illness, which has dominated health care for the past century…" and then goes on to discuss a model with treatments that satisfy the OAM/Cochrane/IOM committee definition criteria by being “healing resources ... other than those intrinsic to the politically dominant health system”. But again, they are not CAM. Cochrane is MEDRS. If an otherwise MEDRS source like Cochrane makes a demonstrable error, but we have no RS pointing out that error, should that error still be repeated in Wiki? FloraWilde (talk) 11:15, 5 June 2015 (UTC)

First, can I extend my sympathies, sincerely, in regard to this dilemma.

The argument seems to run that an excellent source has defined the biomedical paradigm as the 'dominant model of disease'; that this same source criticises the biomedical model and proposes a biopsychosocial model in its stead; that the biopsychosocial model was then applied and informed treatment modalities; that such treatment modalities are equivalent to the IOM definition of CAM because they are 'healing resources ... other than those intrinsic to the dominant health system'; yet we do not define these treatment modalities as CAM; therefore this definition is incorrect; do we really need a RS to remove this incorrect information from wikipedia.

We had a user a while back who used a similar argument (lack of evidence-base for psychiatric entities and treatments) to a different end - they wanted to classify psychiatry as a form of alt med.

The short answer, what people will give you in the world of Wikipedia, is our concern is with 'verifiability not truth'. This means that, even if you are an expert in a given field and know that a source, which is otherwise regarded as a reliable source here, is highly unsatisfactory, it may be difficult to argue for its exclusion. So yes incorrect information or perspectives may be included if they are representative of the breadth of sources and not undue.

Using WP policy & guidelines, I could, perhaps attack the citing of this (classic and very important) medical article on the basis that it is old (almost 30 years) and does not adequately represent the contemporary situation. I wouldn't actually though. It's hard to overstate its importance to psychiatry. Also, there are many other sources that state the biomedical paradigm is central to modern mainstream medicine.

A number of points should be made though. First, all the definitions of CAM are inadequate and could be shown to be false to some degree. This is also true of the definitions that state that there is only medicine that works and non-medicine, or medicine that has an demonstrable evidence-base and medicine that does not, because a fair proportion of mainstream non-CAM treatments don't work, or don't work adequately, or lack a significant evidence base, or the evidence base may suffer from various biases, etc (or to be more accurate, we have a couple of high quality RS - other than Wieland - who state this for us). This is probably particularly true of psychiatry which, normally, is not defined as a species of CAM and is equally not normally defined as non-medical. We shouldn't be here to promote a given definition unless the breadth of sources indicate that there is one sufficient and dominant definition. There isn't. Most sources that consider the topic state how difficult it is to define CAM and that we lack an adequate definition. So we have to do some kind of job of representing the breadth of sources, without being undue, and detailing the various definitions and their inadequacies as indicated in those same sources.

Another point regarding your argument above is that you conflate the 'biomedical paradigm' with the 'politically dominant health system' when these are quite different things. The first is an explanatory model and a perspective which may inform practice and method (and can also be used in ideological conflict, perhaps righteously) but differs to how a health system is organised, its political and institutional structures, how resources are disbursed within it, questions of access, and so on. A real world health system can contain a lot of contradictory elements and perspectives on health and its measurement may differ radically between say, surgical and rehab departments, say.

Lastly, there's a specific context for Engel's article and its adoption when psychiatry was being attacked from within and without and had been unable to entirely establish itself within a purely biomedical paradigm. In part, the ready adoption of the biopsychosocial model represents a political settlement within the various schools of psychiatry, in a US context and more generally, between psychoanalysts (defined as pseudoscience on WP), social psychiatrists and biomedical psychiatrists. The turn in more recent years has been pretty strongly but not exclusively towards a biomedical model in psychiatry - that's where the funding seems to go - notwithstanding continuing problems establishing the effectiveness of some of its treatment modalities and scientifically delineating psychiatric entities.

To describe another issue, the meta-analyses signalling the clinical efficacy of CBT for psychosis are probably deeply flawed. Absent sufficient rebuttal, we may have, or could have, an article on here stating that CBTp is effective (I haven't checked). If we do, it may be bugger getting such inaccurate information removed until sufficient rebuttals are produced in the real world. FiachraByrne (talk) 13:42, 5 June 2015 (UTC)

The upshot is that the OAM/Cochrane/IOM committee definitions are either rule of thumb definitions like NSF, or are definitions that represent some perspective, or were made to be used to achieve some goal (e.g., the CAM committee says it was chosen by IOM to represent CAM perspectives, and the report states one of the committee goals was to increase CAM usage). They are not theoretical definitions as our article says. FloraWilde (talk) 15:43, 5 June 2015 (UTC)

@FiachraByrne:It's been quite a while since wp:V said wp:VNT. There was considerable debate about wording change in the lede of wp:V, and the conclusion was an improvement. Perhaps a refresher read is overdue? LeadSongDog come howl! 16:25, 5 June 2015 (UTC)

Ah, thanks for the notice; it changed while I was inactive. FiachraByrne (talk) 20:52, 5 June 2015 (UTC)

The exact wording may have changed, but the principle is still valid. -- BullRangifer (talk) 04:23, 6 June 2015 (UTC)

Alternative Therapies in Health and Medicine is a questionable source

Alternative Therapies in Health and Medicine is multiply cited in our article. I did two random searches from the topic buttons at their website, and excerpted from about 80% of the abstracts that popped up. Most of the articles were written by MDs or PhDs from the epidemic of integrative medicine departments infecting hospitals and universities. Here are excerpts from those abstracts.

• “…remedies… classified as homeopathic remedies... were used… to successfully treat patients…”
• “…studies have confirmed the existence of measurable EQ (external [[qi]) effects"
• “...As distant healing becomes a valid object of scientific scrutiny, state-of-the-art statistical techniques point to outcomes clearly outside the realm of chance….”
• “ … healing at a distance... So what can we say about how these events happen? The question of how healing happens is tightly connected with language and taxonomy, because the language used in this field often presumes or implies a mechanism—as when we say “nonlocal healing” or “energy healing.”
• “Touch therapies... eg, ... Reiki... there is evidence supporting the clinical value of these therapies”
• “…This case report describes how one PLWA (patients living with AIDS) successfully used a hospital-based Reiki treatment…”
• “…selected research on spiritual healing... recommendations for future research.”
• “…chaos and complexity theory… may advance understanding of the mechanisms of homeopathic remedy effects… This approach may… elucidate similar effects of other energy medicine modalities…”
• “The homeopathic conundrum revisited – homeopathy... ultramolecular doses of medicine have prolonged and fundamental therapeutic effects that are sometimes as great as those produced by very powerful pharmacological agents such as antibiotics…”
• “The role of homeopathic... for recovery after surgery merits further investigation.”
• “Twenty pigs were randomly assigned within a stall and were administered either antibiotics, homeopathy, or placebo… Homeopathic metaphylaxis is significantly effective compared with placebo and routine low-dose antibiotic…”

It goes on and on and on like this. This source fails both NPOV and RS (and is not even close to being MEDRS). We should be careful about checking the reliability of our sources. FloraWilde (talk) 03:01, 5 June 2015 (UTC)

Pretty whacky. Arent' the authors, though, the members of the Cochrane CAM field? Also, without having reexamined the article, isn't the source used to support content on definitions on CAM rather than biomedical claims. For what its worth, the article is also cited by 2 PLOS ONe and one BMJ article [50] [51] [52] FiachraByrne (talk) 09:12, 5 June 2015 (UTC)

I was thinking of this cite we used - "Katz, D.L. et al. (2003). "The evidence base for complementary and alternative medicine: Methods of evidence mapping with application to CAM". Alternative Therapies in Health and Medicine", to support "In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis". I was going to use this journal to support an edit saying something like "the quantity or quality of underlying evidence for CAM are overly simplistic", summarizing that article's conclusion that, "The novel methods of evidence mapping reported are useful and practical in characterizing the extent, distribution, and methodologic quality of research pertaining to a broad topic in medicine. Applied to CAM, they suggest that summary judgments about the quantity or quality of underlying evidence are overly simplistic." The main author was from "Yale Prevention Research Center, Department of Epidemiology and Public Health, Yale University School of Medicine". I like having more than one source for an edit, so I looked for a second source, starting at the website for "Alternative Therapies in Health and Medicine", and seeing a bunch of MDs and PhDs as their authors. When I started reading the abstracts, I got what I listed, and it went on and on. Why would a Yale team publish in this journal unless their submission was rejected by real journals. So I decided not to make the edit because I did not trust anything published in this journal as having hidden reasons for selecting that journal to publish in.

This is a change of subject, but the BMJ you link to[53] says, "...Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM (complementary and integrative medicine ) therapy versus usual care... Conclusions... evidence of cost-effectiveness and possible cost savings in at least a few clinical populations..." Note that they did not study "CAM", but "CIM" (complementary and integrative medicine). Since MDs are supposedly bound to use best practice biomed, but CIM doctors then top it off with an alt med treatment, the logical inference that can be made is that CIM doctors are either charging less for giving the same biomed treatment as a non CIM doctor, or they are not following best practices recommendations. FloraWilde (talk) 10:18, 5 June 2015 (UTC)

I take your point and, I think where biomedical claims are being made, particularly of the rather extraordinary nature that you list above, there are much better publications to call upon. However, Wieland et al., insofar as definitions of CAM are concerned, are a highly relevant source given their work with the Cochrane CAM field which is run from the School of Medicine, University of Maryland (where Wieland is based). See the lead authors pub record here [54]. Now, some of the stuff in that article is inappropriate for inclusion here for a variety of reasons. But, I think, given their role with Cochrane, it is hard to argue that the authors don't play a significant role in defining in practical terms what is and is not CAM.

There are lots of sources in the article of questionable provenance - I've removed a couple myself recently. Maybe we should go for the low-hanging fruit first (self-published websites, etc.) and then see where we stand on this and other items likely to provoke debate?

Re the BMJ, that seems a fair reading, but I'm not here to argue that CAM/CIM is great/terrible, the studies chosen are poor/excellent methodology, etc. In certain aspects, you have to turn off your critical faculties when editing WP - particularly with sources you know are shit but which meet reliable source criteria for medical or non-biomedical topics (this doesn't mean you have to add bad material from RS sources, but it does mean it can be hard to argue for their removal).FiachraByrne (talk) 10:42, 5 June 2015 (UTC)

Incidentally see this recent discussion at WP:MEDRS. FiachraByrne (talk) 10:55, 5 June 2015 (UTC)

Yikes. All that talk page discussion went nowhere. Should I strike my section below, since it makes no suggestion for any insertion or deletion in the article, so may generate much talk page discussion without a point? FloraWilde (talk) 13:00, 5 June 2015 (UTC)

Nah. Only strike if think you really made a serious mistake. I don't think it's necessary and your points all have a validity. The main thing on an article like this is to build a community of editors who, while their views may differ, are respectful to each other, want to produce a decent article, can listen as well as talk and don't try and game processes to 'win'. In that regard, things are quite good here at the moment not least because we can do that while holding significantly different perspectives. FiachraByrne (talk) 13:50, 5 June 2015 (UTC)

FloraWilde, I commend you for your shrewd used of common sense in exposing this example of how quackademic medicine uses publications to lend authority to its dubious assertions.

FiachraByrne, you are so right that "it is hard to argue that the authors don't play a significant role in defining in practical terms what is and is not CAM." They are muddling the waters by claiming that alternative medicine has (extremely dubious) proof of effectiveness, and thus use their influence to promote the acceptance of alternative medicine as being equally legitimate as mainstream, EBM, medicine. They are masterfully piloting a Trojan horse and are not trustworthy. This is so egregious as to be worthy of their names being mentioned as red flags in a FAQ at the top of this talk page. -- BullRangifer (talk) 04:17, 6 June 2015 (UTC)

Eh, no, we won't be putting a FAQ with their name on it on the talkpage because we should at least maintain some pretence of NPOV. We reflect the sources and they are a significant source, particularly for the definition of CAM, so we put that in. If they're making outrageous biomedical claims in this kind of journal we don't put that in. If you have a decent RS describing them as a Trojan horse for the insidious infiltration of quackacademia into the pristine citadel of biomedicine we can include that. And we probably should have a section giving better coverage of 'integration'/'cooption'/'infiltration' of CAM into the mainstream, responses to that (not simply polemics but an analyses of institutional and other responses and factors driving or acting against 'integration'/'infiltration'. FiachraByrne (talk) 16:19, 6 June 2015 (UTC)

Are there RS for adding "therapy that has a non-scientific explanation" and "type of spiritual practice" to def of alt med?

The definition from the editor-in-chief of Medical Hypotheses is[55]

• "therapy that has a non-scientific explanation" - Bruce G Charlton MD, Editor-in-Chief, Medical Hypotheses, Newcastle University.

(That's how I defined alt med before I ever read the Wikipedia article.) FloraWilde (talk) 15:11, 5 June 2015 (UTC)

FloraWilde, this is strong for the reason that when your enemy supports you, they have provided the strongest evidence you can get. Medical Hypotheses is not considered (at Wikipedia) as a RS for medical facts. It's a very fringe source which is generally on the side of alternative medicine. Here we have them providing a very accurate description, which is essentially an admission of guilt, and we should use it. This is excellent for content. -- BullRangifer (talk) 04:34, 6 June 2015 (UTC)

@BullRangifer, It is very concise and best reflects my own rule of thumb def. But the source is not RS, and it also has porous boundaries. E.g., a real life example is that a gastroenterologist recommended Pepto Bismol to me for diarrhea (bismuth subsalicylate), and said "we don't know how it works". It has been around since before statistical testing came into being, and its efficacy is so immediate and obvious that it is unlikely it was ever rigorously subjected to scientific testing (before competitors came up with other products and may have done tests to compare relative efficacy). So at that time Pepto Bismol lacked a scientific explanation, and had not been proven effective with scientific testing. But Pepto Bismol is not alt med. FloraWilde (talk) 11:28, 6 June 2015 (UTC)

1. It's reliable for it's own POV, just as many other sources we use. Since it's accurate for pretty much all alt med, I think we can use it. Go for it!
2. I wouldn't worry about the "porous" aspect, since that's a historical matter. Mainstream practice used to be the only practice, and it included all kinds of inherited practices, many of which were very harmful and nonsensical when seen with our modern eyes. The evidence based medicine movement has sought to deal with this by applying research based knowledge to a winnowing out process in which the wheat is separated from the chaff. Alternative medicine has no such process. Obviously nonsensical or dangerous practices get dropped from mainstream medicine, but never from alt med.
   Others of a more innocuous nature may still be in use in mainstream medicine, even though they don't have a strong evidence base. Time will tell. As long as it actually does work, we tend to continue to use it, since an explanation is not a necessary requirement for inclusion in EBM. The most important requirement is a good risk-benefit ratio.

BullRangifer (talk) 16:52, 6 June 2015 (UTC)

And what do you (User:FloraWilde) think now? ;)

It's a valid definition, as definitions go, but there are many definitions and they're inconsistent.FiachraByrne (talk) 15:31, 5 June 2015 (UTC)

What do I think now, after reading Wiki? Off Wiki, I say (but do not think) the same definition as before reading Wiki: "medicine that is based on nonsense" is the rule of thumb definition. (I usually add that most newly marketed biomedicines are based on abuse of statistics or junk-statistics.) But what I think is the same as always, that the real definition is "religious medicine". This is because I was there to experience the whole history, from the new age movement origins, to watching it grow. More importantly, I directly experienced the "believer reaction" to any criticism of it, which is identical to the reaction of a religious zealot.

Here is a recent example of my actual thoughts. A month ago, I had a conversation with a national part botanist (a self-proclaimed atheist). It was going very well, until I complained about the incessant abuse of language in field guides, in particular a book (which I cited as RS about 300 times in just one article at Wiki,[56] and I likely cited five or ten times that many times in related articles.) It has scientific descriptions and interesting comments of species that can only be found collected in such a plant field guide. Then it adds stuff like "USA Today reported that this plant may become as popular a natural remedy as Echinacea...", and "Herbalists and Native Americans employed various species of Asclepias as... remedies for lung problems...", and "The Paiute and Shoshone... used it as a remedy for colds, urinary tract infections, and venereal disease". Hidden in one species description of a very toxic plant that had similar traditional use, is a disclaimer "Many species of Senecio have been used as alternative treatments... toxic... Just because a treatment is natural does not mean it is healthy or devoid of side effects! Please remember that the information on plant 'uses' in this book is never given to promote the use or any plant for food or medicine, but rather it is included for general interest..." That disclaimer is not in the nontoxic species descriptions, leaving the reader of those descriptions with the belief that it might be a useful "natural" medicine .

The fact is that adding uses as alternative medicine, and doing so without being critical of their being based on nonsense, sells the plant field guide, to buyers who do not even read the scientific description part. I complained that all botany field guides are jumping on the profitable band wagon of implying efficacy by ambiguously referring to "use". I started a discussion about all this at Wikiproject Plants last July[57], where there was unanimous consent, then I came to the alt med article, but found what we experience on this talk page.

Then the botanist and self-declared atheist that I was talking to stiffened, her facial expression turned to defensive anger, and she said just used such-and-such tea for her daughter's cold, and her daughter eventually got better. I internally thought, "uh, oh, an alternative medicine pseudo-atheist's religious reaction to criticism of their unscientific beliefs. I should shut up now before making an enemy or getting into a religious discussion". I quickly changed the subject, the same as I would if I had just made fun of the local church service and found out she was part of it. So that is literally what I think (post Wiki), since those were my actual thoughts.

I also now think I cannot get away from these kind of thoughts, because the next plant field guide I use for a reference will have similar language implying that "alternative medicine" is an alternative, and implying efficacy by use of ambiguous language about Native Americans et al. That is what sells the plant field guides. I think that the next purported scientific-botanist I meet will likely have a similar such testimonial/anecdote, and religious reaction if I say anything critical of alt me.

I never added any of this "thinking" to the article because I did not find any RS source about it, especially about how alt med is better classified as a religion than as medicine. The RS article I just came across by Google Scholar searching "alt med and new age" has what I thought pre-Wii, but I fear trying to add it would destabilize the article and waste more of my time at talk. FloraWilde (talk) 16:44, 5 June 2015 (UTC)

• "...alternative therapies are not a part of science, but should instead be considered part of NewAge spirituality." - Edzard Ernst, 2013[58]

• "Alternative medical therapies should be considered part of New Age spirituality"- Bruce G. Charlton[59]

These sources inaccurately omit Christian faith healing, etc., which is not new age. I cannot find a source for "alternative medicine" is a kind of religious belief system". I cannot find any source on the religious-style "faith" reactions to criticism and couter-evidence.

Also,

• "spirituality and religiousness are associated, in unique ways, with CAM use." - Preventive Medicine[60] FloraWilde (talk) 20:35, 5 June 2015 (UTC)

Thank you. I enjoyed that very much. I'll see what I can find in the sources I have access to. FiachraByrne (talk) 20:44, 5 June 2015 (UTC)

Here's one:

Hughes, Brian M. (2006-12-01). "Regional Patterns of Religious Affiliation and Availability of Complementary and Alternative Medicine". Journal of Religion and Health. 45 (4): 549–557. ISSN 0022-4197. JSTOR 27512967. Retrieved 2015-06-05.

The generally poor performance of CAM in clinical trials coupled with its ever-increasing popularity raises the fundamental question of why its use has become so prevalent. Some attempts to account for this phenomenon have pointed less than flattering fingers at decreasing popular understanding of and respect for science, and increasing level of popular neurosis, or a mass failure of rational thought and critical judgement on the part of the population (cf., Furnham, 1997). Alternative explanations have focused on consumers' dismissive attitudes towards science, with some authors suggesting that the willingness of society to receive pluralistic perspectives on medicine can be linked to postmodernism. In this explanation, the emergence of CAM is characterised as a popular deconstruction of the hegemony of biomedical science, and a counter-cultural onslaught against modernist, technologically focused conceptions of progress (Saks, 1998).

— Hughes (2006), p. 550

Article states that research indicates the patients use heuristic reasoning rather than logical rationalism in their health choices so consumers attitudes towards science likely irrelevant. Continues ...

... CAM's fluctuating popularity might be associated with other more indirect trends involving care-giving social roles and mysticism. One possibility is that the increasing popularity of CAM may be the result of a decline in the social acceptability of other mystical belief practices, such as the observance of formal religions. It is conventionally accepted that the observance of formal religions involves the acknowledgement of faith in fixed set of prior assumptions in the absence of empirical evidence in their support. [...]

... whereas modern (Western) societies have become identifiably more secular, this may not necessarily imply that citizens have lost their appetite for mysticism. The attention given to CAM may be a displaced version of the attention previously devoted to orthodox religions. ... However, theories that link increasing CAM popularity to declining religious observance have not been empirically tested

— Ibid., p. 551

Author then attempts such a study on Ireland (apparently there's been a rapid growth of CAM here which I've remained largely unaware of, though I did see my mother-in-law stick candles in her ears once and thought that was a bit wierd; I can attest to the fact there has been a some fall off in formal religious practices in Ireland). Takes data on religious observance from 2002 census figures and computes them for 30 regions in Ireland. Then author inferred CAM usage from CAM availability from Golden Pages (yellow pages in US, now defunct really). Finds a 'statistically significant inverse correlation between religious affiliation and CAM provision of r = -.57 p = .002).' Concludes that 'CAM may be filling a mysticism void'.

If you want a copy, send me an email. I'll see what else is out there. FiachraByrne (talk) 21:50, 5 June 2015 (UTC)

Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann (November 2011). "Patients' views of CAM as spiritual practice". Complementary Therapies in Clinical Practice. 17 (4): 221–225. doi:10.1016/j.ctcp.2010.12.001. ISSN 1744-3881. Retrieved 2015-06-05.

Narrative study of 4 patients.

Conclusion: It is suggested that for some cancer patients CAM may function, not just as a treatment for cancer related symptoms and side effects, but also as a form of spiritual practice. For some individuals a belief in the ‘spiritual’ role of CAM per se may be analogous to religious belief.

FiachraByrne (talk) 22:01, 5 June 2015 (UTC)

This one seems to contradict the previous (weak) Irish study

Amin, Mohamed; Glynn, F.; Rowley, S.; O’Leary, G.; O’Dwyer, T.; Timon, C.; Kinsella, J. (August 2010). "Complementary medicine use in patients with head and neck cancer in Ireland". European Archives of Oto-Rhino-Laryngology. 267 (8): 1291–1297. doi:10.1007/s00405-010-1223-1. ISSN 1434-4726 0937-4477, 1434-4726. Retrieved 2015-06-05. {{cite journal}}: Check |issn= value (help)

Abstract: The objectives of the study were: first, to determine the prevalence of traditional medicine (TM) and complementary and alternative medicine (CAM) use in head and neck cancer patients in Ireland; second, to educate ourselves on the plethora of CAM/TM options available to patients outside the dominion of conventional medicine. The study design consisted of a cross-sectional survey carried out in three head and neck cancer centres. Self-administered questionnaires were distributed to 110 head and neck cancer patients attending the three cancer centres and data were collected for statistical analysis. A total of 106 patients completed the questionnaire; 21.7% of the participants used CAM/TM since their diagnosis with head and neck cancer. CAM/TM usage was higher in female (34.3%) than in male patients (16.2%). CAM/TM use was more common in the 41-50-year age group, in patients with higher educational levels and those holding strong religious beliefs, and also in married than single patients. The most common types of CAM/TM used were spiritual and laying on of hands. The most common reasons reported for using CAM/TM were to counteract the ill effects of treatment and increase the body's ability to fight cancer. Sources of information on CAM/TM were friends (65%), family (48%) and media (21%). This survey reveals a high prevalence of CAM/TM use in head and neck cancer patients, hence emphasising the need for otolaryngologists to educate themselves on the various therapies available to be able to provide informative advice. There is an urgent need for evidence-based investigation of various CAM/TM therapies currently offered to patients.

I'm not finding a lot out there as of yet - actual studies are very limited and look very weak. FiachraByrne (talk) 22:29, 5 June 2015 (UTC)

Curlin, Farr A.; Rasinski, Kenneth A.; Kaptchuk, Ted J.; Emanuel, Ezekiel J.; Miller, Franklin G.; Tilburt, Jon C. (2009). "Religion, clinicians, and the integration of complementary and alternative medicines". The Journal of Alternative and Complementary Medicine. 15 (9): 987–994. Retrieved 2015-06-05.

Abstract: Objective: The aim of this study was to compare religious characteristics of general internists, rheumatologists, naturopaths, and acupuncturists, as well as to examine associations between physicians' religious characteristics and their openness to integrating complementary and alternative medicine (CAM). Design: The design involved a national mail survey. The subjects were internists, rheumatologists, naturopaths, and acupuncturists. Measures: Physician outcome measures were use of and attitudes toward six classes of CAM. Predictors were religious affiliation, intrinsic religiosity, spirituality, and religious traditionalism. Results: There was a 65% response. Naturopaths and acupuncturists were three times as likely as internists and rheumatologists to report no religious affiliation (35% versus 12%, p<0.001), but were more likely to describe themselves as very spiritual (51% versus 20%, p<0.001) and to agree they try to carry religious beliefs into life's dealings (51% versus 44%, p<0.01). Among physicians, increased spirituality and religiosity coincided with more personal use of CAM and willingness to integrate CAM into a treatment program. Conclusions: Current and future integrative medicine will be shaped in part by religious and spiritual characteristics of providers.

FiachraByrne (talk) 22:35, 5 June 2015 (UTC)

Miller, Jennifer L.; Cao, Dingcai; Miller, Jonathan G.; Lipton, Rebecca B. (2009-08). "Correlates of complementary and alternative medicine (CAM) use in Chicago area children with diabetes (DM)". Primary Care Diabetes. 3 (3): 149–156. doi:10.1016/j.pcd.2009.06.006. ISSN 1751-9918. Retrieved 2015-06-05. {{cite journal}}: Check date values in: |date= (help)

Aims: To correlate complementary and alternative medicine (CAM) use in children with diabetes mellitus (DM) with DM control and other family or disease characteristics. Methods: Parents/guardians of children with DM were interviewed about demographics, clinical characteristics, CAM use, health care beliefs, psychosocial variables, and religious beliefs. The child's hemoglobin A1c (HgbA1c) value from the visit was collected. Statistical analyses included ?2, Fisher's exact test, and 2-sample t-tests. Results: 106 families with type 1 DM were interviewed. 33% of children tried CAM in the last year; 75% of parents had ever tried CAM. Children most commonly tried faith healing or prayer; parents most commonly tried faith healing or prayer, chiropractic, massage, and herbal teas. Children were more likely to have used CAM if their parents or siblings used CAM or their family was more religious. They were more likely to have discussed CAM with their providers if they used CAM. Parents of child CAM users reported more problems with DM treatment adherence. Conclusions: Children with DM used CAM. There were no differences in DM control, demographics, healthcare beliefs, stress, or quality of life between CAM users and non-users. Practitioners should inquire about CAM use to improve DM care for children. FiachraByrne (talk) 22:48, 5 June 2015 (UTC)

By the by, of the two sources you list above, I'd have no problem with an attributed quote to Ernst. He's a very significant figure in the field. Medial hypotheses is a funny old journal, although quite fun (I remember reading an article there linking increasing heel size to an increase in the incidence of schizophrenia); I can't quite remember but I don't think they really apply a peer-review process. Charlton may be significant, I don't know. FiachraByrne (talk) 22:48, 5 June 2015 (UTC)

Not sure you'd really like this one:

Koch, Anne; Binder, Stefan (2013-01-01). "Holistic Medicine between Religion and Science: A Secularist Construction of Spiritual Healing in Medical Literature". Journal of Religion in Europe. 6 (1): 1–34. doi:10.1163/18748929-89100001. ISSN 1874-8929. Retrieved 2015-06-05. A particular formation can be observed in the discourse of spiritual healing and complementary and alternative medicine (CAM). Explanations of the effectiveness of spiritual healing by medical doctors and psychologists sometimes include ideological and non-scientific conclusions and concepts, which are similar to but also different from New Age science on healing. With discourse analysis discursive nodes and strategies are identified in international medical and psychological research journals at the boundary of CAM, traditional medicine, and psychosomatics from the last decade. The article develops the category of secularism to describe these propositional formations and contributes to the larger debate of postsecular societies. Postsecularism not only puts public religion but also secularisms back on the agenda. This particular secularism in the field of spiritual healing is based on transfers of knowledge and practices between subareas of a functionally differentiated society: esoteric and scientific cultural models shift into medicine, and continue into the area of health care and healing. The article demonstrates how this secularism gathers around key concepts such as emergence, quantum physics, and physicalism, and is engaged in a permanent boundary work between conventional and alternative medicine, which is governed by the notion of holistic healing.FiachraByrne (talk) 23:11, 5 June 2015 (UTC)

Ellison, Christopher G.; Bradshaw, Matt; Roberts, Cheryl A. (2012-01). "Spiritual and religious identities predict the use of complementary and alternative medicine among US adults". Preventive Medicine. 54 (1): 9–12. doi:10.1016/j.ypmed.2011.08.029. ISSN 0091-7435. Retrieved 2015-06-05. {{cite journal}}: Check date values in: |date= (help)

Objective: To determine whether spiritual and religious identities predict complementary and alternative medicine (CAM) use above and beyond other known influences such as gender, region of residence, social status, personality, health, and access to conventional medicine. Methods: Analyzing data from the 1995-1996 National Survey of Midlife Development in the United States (n = 3032), this study examines the correlations between four aspects of spirituality/religiousness-i.e., spiritual only, religious only, both spiritual and religious, and neither spiritual nor religious-and six measures of CAM. Results: Compared with spiritual only persons, the odds of using energy therapies are 86% lower for spiritual and religious persons, 65% lower for religious only persons, and 52% lower for neither spiritual nor religious persons. Compared to spiritual only persons, spiritual and religious individuals are 43% more likely to use body-mind therapies in general; however, when this category does not contain prayer, meditation, or spiritual healing, they are 44% less likely. Religious only individuals are disinclined toward CAM use. Conclusions: After controlling for established predictors including educational attainment, personality, social support, and access to conventional medicine, the present study demonstrates that spirituality and religiousness are associated, in unique ways, with CAM use. Additional research on this topic is clearly warranted. FiachraByrne (talk) 23:11, 5 June 2015 (UTC)

la Cour, Peter (2008-12). "Rheumatic disease and complementary-alternative treatments: a qualitative study of patient's experiences". Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases. 14 (6): 332–337. doi:10.1097/RHU.0b013e31817a7e1f. ISSN 1536-7355. PMID 18827715. {{cite journal}}: Check date values in: |date= (help)

RESULTS:Rheumatic disease patients expressed use of CAM as methods of regulation of discomforts, the feeling of the body, and self-empowerment, not for unrealistic healing of their rheumatic disease. They experienced a variety of effects, most often expressed in terms of mind-body interrelated experiences, such as "lightness of the body" rather than relief in specific symptoms. They expressed the feeling of "have been helped" when leaving a CAM-session and appreciated to have more than 1 way to understand their disease and symptoms. They were usually not naive, but were critical consumers. The patients typically believed in the alternative viewpoints of "natural is best" and in "energy meridians," but they were otherwise not believers in any alternative, "new age"-type worldview.

FiachraByrne (talk) 23:18, 5 June 2015 (UTC)

I did not look into whether Medical Hypotheses is reliable, but I will be sure to check my heel size each day. Nothing above is very usable to support Ernst's opinion (which was identical with mine). All are either opinions or speculations on causes of belief in CAM section. I briefly looked when I made some edits here last summer, but found nothing solid. There may be something in this (which I have not read), because Dawkins talks about alt med in it (according to Google).

I assume by "here" you are in Ireland, and by your remark about not noticing the rapid growth in CAM, there is not a chiropractor or acupuncture office that recently opened in every strip mall, and an entire drug store or supermarket section devoted to dietary "supplements" and homeopathic remedies? If not, give it another year or two.

If you want to acquire your own anecdotal evidence for the Ernst remark, go challenge the single mom who just spent half her dole check on homeopathic pills, acupuncture, and chiropractic for her infant with influenza, because an MD said there is no known treatment, especially if you make the challenge after the kid gets better. After observing her reaction when you mention how homeopathy is inconsistent with basic physical chemistry, you will hear your own inner voice quoting Edzard Ernst to you. So something like the Ernst quote will be what you literally think. It's the style of conviction of belief, and reaction to challenges to the belief, that makes the belief seem best categorized as a spiritual or religious belief.

I want to change my comment above. Before reading the Wiki article and its sources, when my knowledge of alt med came from personal interaction with users and not from reading anything about it, I thought just like Ernst (I maybe even thought his exact quote). After reading Wiki and sources, I would replace "new age" with "religion", because of the statistics on use of prayer, etc. FloraWilde (talk) 23:25, 5 June 2015 (UTC)

Yeah, I've been spamming really. I should stop that.

Irish Times 16 Nov 1907, Advertisement by the Pulvermacher Electrological Institute, titled, 'Is Electricity Superceding Medicine?'

Heel size abstract available here [61]; full text is probably online somewhere. Satire, I assume, but worth a look.

Saks is probably the most usable source for linkage of CAM to 'counter-culture'.

Personally, I'm a bit resistant to the use of figures like Dawkins or Sagan. There's no doubting their status within their own fields but I don't feel like they have much expertise on this subject other than statements that certain CAM claims are implausible, contradict basic scientific principles, etc.

Now that you mention it, we do have most of things (not so certain on prevalence of chiropractors); I guess it just doesn't register with me. Also alternative medicine or various traditional and folk healers have always been active to some degree.FiachraByrne (talk) 00:42, 6 June 2015 (UTC)

What spamming? You found good RS, e.g., Saks. FloraWilde (talk) 21:00, 6 June 2015 (UTC)

Treating other editors on talk pages of edit-warred articles

In remarks above, FiachraByrne stated a failure to notice the rapid rise of entire sections of supermarkets being devoted to dietary “supplements” and homeopathic “remedies”, and TCM/acupuncture or chiropractic offices opening in strip malls everywhere, but later admitted they were there all along (except for chiropractic in Ireland), stating it “it just doesn't register with me”. This indicates an attention deficit. FiachraByrne needs to be treated for this attention deficit. Wikipedia provides guidelines for treating other editors, but I suggest an alternative treatment to "complement" what is recommended at Wikipedia. From the sparse contribution of FiachraByrne to this talk page, as indicated by the above sections, there is no indication of hyperactivity by Fiachrayrne (or me). But the the TCM perspective is that, “Attention deficit can occur alone or with a hyperactive component.” Two major RS on their own perspectives agree that “The causes of AD/HD in Traditional Chinese Medicine TCM terms are Liver wind rising with shen (mind and spirit) disturbance arising from Liver yin deficiency also present are heart and spleen qi deficiency. Attention deficit can occur alone…”[62][63]

The second source goes on to state the "western perspective" on ADHD, but that source is not RS (and certainly not MEDRS) for stating the western perspective. We can calculate the total “western perspective”, using RS for the “US perspective”, together with RS for actual numbers needed for the calculation. The "US perspective" is “between $36 and $52 billion” annually[64]. According to Wikipedia, the US population is 321 million, and world population is about 7 billion. 321million/7,00 million is about .05, so the western perspective on treating ADHD is approximately a potential 1/.05 x $36-52 billion, which is about $700 Million to over $1 Billion.

Therefore, the overall “western perspective” on treating people with conditions like that of editor FianchraByrne is (potentially) between $700 Billion annually, to over $1 Trillion annually. With such treatment, they may no longer fail to pay attention to the rapid rise of availability of alternative treatments right around the corner. If the committee reporting to the IOM achieves its goal of including CAM as among a patient's healthcare choices, according to Acupuncturetoday.com on treating attention deficit disorers,[65] “A combination of all these modalities (TCM and western) ensures long-term succe$$”.

There is a serious point to the above quotes and calculations. By giving undue weight to the truly miniscule percentage of overall alt med, that is either biologically plausible or has some evidence, our article fails to leave the reader with a sense of how utterly loony most alt med is (from Wikipedia standards of having an objective science based perspective of a serious encyclopedia). For example, mentioning needling a point for marginal nausea control, compared to acupuncture being used to treat almost every illness, is greatly undue. Our article also fails to state a major motivation of alt med, to get a piece of the dollar pie of nearly equally loony amounts of money being made in biomedicine for treatments and conditions that are marginally effective or marginally existent at best. There must be RS for these two points. FloraWilde (talk) 13:44, 6 June 2015 (UTC)

Advertisement for anti-rheum-gem jewellery to cure rheumatism, gout, sciatica, Westmeath Examiner [Ireland] 30 April 1904

Nah, I'm okay as long as I've got my anti-rheum-gem to keep me safe.

I'm not sure how you come to your present reading of the article. To my mind, it states repeatedly that alt med does not work, is not based on science etc. It's entirely right that the article should state that prominently and probably earlier (after the lead) then it does now. But once said, there's no need to keep repeating the fact as if we don't trust the reader to retain that information. It is in fact very repetitious and doesn't address other pertinent topics. I can't imagine any other type of general encyclopedia presenting alt med this way. I'd certainly like a clearer presentation of the industry, economics and consumption of alt med, etc.

Article is badly in need of restructuring and rationalisation - to cut down on repetition if nothing else. Section on prevalence of usage should be brought together with/placed before section on reasons of popularity (can't remember section name). Definitions section is also now far too long and needs to be rationalised (some of the definitions are repeated several times and in sections that have nothing to do with definitions. History section needs a redo and should be moved further down article. Not saying that MedMos should apply throughout article but might be worth looking at using a modified version of MedMos to rationalise structure. FiachraByrne (talk) 14:30, 6 June 2015 (UTC)

FiachraByrne is entirely correct about the repetitive (and plodding, committee-product) nature of the article as a whole, which I referred to as a "morass" above. I went to find basic definitions, and could not find them. I thought "standard medicine" meant "best practice", so the way it was used in the article made no sense to me.

When I first read the Wiki article, it left me with the impression that some of alt med is nonscientific, or even nonsense, but that some of it warrants spending money to test, the same as new ideas in biomed need testing, and old untested treatments from the 1800s and early 20th century still need to be put to the test. I got a similar impression from the media, that "there is some evidence for acupuncture", etc., and wondered what related but different things lay under the skin at 365+ points, for a needle to stimulate and trigger a physical response at an apparently unrelated part of the body, in 365+ ways. I thought my previous idea of alt med as being ridiculous new age nonsense was parochial, based only on my limited, non-representative personal exposure to a small part of alt med.

Then when I finally actually read an alt med website with a real start to finish description, like the one I just quoted, I had an entirely different picture in my mind than what I had from reading the Wiki article. E.g., reading the theory of diagnosis "liver yin deficiency also present are heart and spleen qi deficiency", the region-color-texture of the tongue that lets one apply the theory , the manipulation of external qi by orienting the house front door correctly in relation to the north pole, location of acupuncture points based on the number of rivers in the old Empire and number of days in a year, and the botanical and animal TCM brew components that accompany the needling, gives an entirely different picture than what one takes away from reading the Wiki article. Reading start to finish for other alt meds is similar. If there is some biologically plausible alt med practice, it is a tiny fraction of what is found in a Google search.

What the article fails to do is give this percentage-plausibility among alt meds, realistic, picture to the reader, which is a bizarre picture to a person with a basic chemistry, biology, physics, and anatomy class under their belt. Perhaps a way to give this more complete picture is to add quotes of actual examples in the examples section. FloraWilde (talk) 17:30, 6 June 2015 (UTC)

Excellent observations. I share your concern. The influence of editors who defend alternative medicine has likely made us gunshy of documenting what's actually out there, so our coverage is far too sympathetic. We are allowed to use unreliable sources to document the existence of unreliable claims. They are good for their own views. -- BullRangifer (talk) 17:52, 6 June 2015 (UTC)

I am partially responsible for pro-POV introduced by UNDUE, that I just complained about. In trying to insure consensus, I added "ranging from being biologically plausible but not well tested, to being directly contradicted by evidence and science, or even harmful or toxic", without indicating that the percentage of the bio-plausible alt med theories may be miniscule compared to alt med as a whole. FloraWilde (talk) 20:18, 6 June 2015 (UTC)

Percent adverse side effects

I removed my own edit[66] - "One study on giving alternative medicine to children, found that in almost 2/3 of 39 adverse incidents reported, the side effects were severe, life threatening, or fatal.". This small single study has too many factors unaccounted for to characterize alt med as a whole. FloraWilde (talk) 13:38, 7 June 2015 (UTC)