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"Controversial" - A simple compromise - I hope...

I'm changing the intro paragraph so that it notes that homeopathy is controversial, and it notes that it's "alternative medicine." But it will not include the phrase "controversial system of alternative medicine," so as to avoid the adjective "controversial" been misread as a modifier of "system of alternative medicine," which would imply that it's more controveral that other forms of alt. medicine. Hopefully this will work for everyone. Intro paragraph:

Homeopathy (also spelled homœopathy or homoeopathy), from the Greek words homoios (similar) and pathos (suffering), is a system of alternative medicine, notable for its use of remedies without chemically active ingredients. The theory of homeopathy was developed by the Saxon physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but is controversial because its principles are contrary to accepted scientific methods and to the principles of conventional medicine.

Blackcats 04:31, 2 Jun 2005 (UTC)

It's inadequate to say that homeopathy is controversial simply because, under well-established principles, it can't possibly work. The experimental results are also important, and were alluded to in the earlier version. At any rate, your attempted compromise has now been replaced by a rapidly pro-homeopathic version. As long as the devotees of homeopathy keep trying to turn this article into a commercial for their particular brand of quackery, the edit warring will continue. (Mind you, I'm not trying to get the article to state that homeopathy is quackery. We don't answer one violation of the NPOV policy by substituting another.) JamesMLane 05:39, 3 Jun 2005 (UTC)

James - the attempted compromise which I edited the article with was a very slightly modified version of what you yourself proposed:

Also, for clarity, I think this lead section should be broken into two paragraphs, and I've made some wording changes from your version (I didn't like "scientific notions", for example). So what about this version:

Homeopathy (also spelled homœopathy or homoeopathy), from the Greek words homoios (similar) and pathos (suffering), is a controversial system of alternative medicine, best known for its use of certain remedies that are so highly diluted as to have no chemically active ingredients. The theory of homeopathy was developed by the Saxon physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but its principles are contrary to accepted scientific beliefs as well as to the principles of conventional medicine.

Homeopathy essentially treats "like with like". The patient describes his or her symptoms in detail. The practitioner considers the physical and psychological symptoms to determine the image of the disease in the patient. The practitioner then prescribes extremely small, nontoxic doses of a substance thought to match the disease image or complex in the patient.

JamesMLane 23:18, 17 May 2005 (UTC)

I simply replaced "scientific beliefs" with "scientific methods" and moved the "controversial" so that it wasn't directly modifying the phrase "alternative medicine." For the record, I'm no fan of homeopathy, and I do feel that it's more dubious than other forms of alt. medicine, but I didn't feel that Wikipedia should assert that as such. Instead it should present the objective facts and let people come to their own conclusions.

Furthermore, the fact that some annonomous IP users (who for all we know could be straw-man internet sock puppets) have been vandalizing the page should have no bearing on any negotiations or attempts at compromise between good faith editors like you and I. --Blackcats 20:22, 3 Jun 2005 (UTC)

The last sentence of the above rewrite is not exactly accurate nor does it make much sense. I'd suggest the following: "The practitioner then prescribes a substance which is considered to produce a similar disease image in healthy persons ("provings"), usually in very dilute doses. --Rudi 03:25, 4 Jun 2005 (UTC)

Blackcats, I agree that the pro-homeopathic editors can't be considered as a monolithic bloc. My point was only that, although I was hopeful that we were making progress toward a consensus version, we have no hope of reaching stability if people come in and make edits like the one the anon made. Also, I don't necessarily agree with everything that was in a prior edit, even one of my prior edits! I think I used the term "beliefs", but then Jooler pointed out, correctly, that this conveyed an inaccurate picture of scientific conclusions (because science isn't a belief system, unlike homeopathy and religion).

And that's why I changed "beliefs" to "methods." I'm sure most every scientist would be happy with that wording. That's one of the first things we went over in most of the science classes I've taken - the scientific method. Blackcats 19:46, 5 Jun 2005 (UTC)

My problem is with flatly asserting that homeopathy is a form of alternative medicine. For treating cancer, chemotherapy, radiation, and surgery are forms of medicine. Crystal healing and the like is not a form of medicine. That's why I wanted to qualify that assertion by including the word "controversial". If that's a problem, I'd be OK with the more direct statement if it's attributed as an opinion, rather than being asserted: "Homeopathy is said by its practitioners to be a form of alternative medicine...." Would that raise fewer hackles than the word "controversial"? JamesMLane 05:06, 4 Jun 2005 (UTC)

James, you seem to be saying that homeopathy is not a form of alternative medicine. If you read the alt medicine article I think you'll see that homeopathy falls well within the accepted definition. --Lee Hunter 13:44, 4 Jun 2005 (UTC)

I agree with Lee Hunter. If you want to argue that alternative medicine is inherently a misnomer, then you should fight it out over there. Once you change the name of that article to controversial medicine or alternatives to medicine or whatever, then we will be happy to change the wording here. Until then, we have other bones to pick. Art Carlson 16:42, 2005 Jun 4 (UTC)

I do think that the phrase "alternative medicine" is a masterpiece of deceptive marketing, but I agree that that's beyond the scope of this article. My only point was to explain why I favored the wording "a controversial system of alternative medicine". Rudi suggested above that saying it's alternative medicine establishes that it's controversial. I disagree, because not everyone knows enough about the field to know that anything called "alternative" is controversial. We should certainly use the phrase "alternative medicine" and wikilink it, but we should include "controversial" so the reader is notified of that key point without having to read the other article. JamesMLane 23:02, 4 Jun 2005 (UTC)

And that was the whole point of my compromise! We would be explicitly stating that it was controversial in the first paragraph, but we wouldn't use wording (at least not in that first paragraph) that could be read to mean that it was more (or less) controversial that other forms of alt. medicine. Blackcats 19:40, 5 Jun 2005 (UTC)

Why say it's a "system of *alternative* medicine"? Wouldn't it be more accurate to state that it's simply a "system of medicine". This would then cover all the families and communities for whom Homoeopathy is the only system of medicine and not an alternative. And why *controversial*? There are two sides to every controversy, which means that all allopathy-related articles would also have to be re-edited and described as *controversial* too. Or is Wikipedia intended as a partisan resource? Unsigned comment by user 62.53.0.87. brenneman^(t)(c) 03:04, 15 July 2005 (UTC)

Scientific Criteria

Could someone explain to me what are the minimum criteria referred to in the intro paragraph? This seems to me to be different and more radical from stating that it goes counter to current principles of science. --Rudi 03:32, 4 Jun 2005 (UTC)

I would also like some clarification of how homeopathy goes counter to the scientific method, rather than to current principles held, based on the following dictionary definition:

The principles and empirical processes of discovery and demonstration considered characteristic of or necessary for scientific investigation, generally involving the observation of phenomena, the formulation of a hypothesis concerning the phenomena, experimentation to demonstrate the truth or falseness of the hypothesis, and a conclusion that validates or modifies the hypothesis. --Rudi 03:37, 4 Jun 2005 (UTC)

One variation of the language that we've used (the one in the article as I write this) is that "neither its empirical nor its theoretical foundation meets the minimum criteria of the scientific establishment."

• The theoretical objection is that there is no known mechanism for "water memory" or anything else that could produce an effect in the absence or virtual absence of active ingredients. The phrase "no known mechanism" can be misleading. Homeopaths seem to be found of saying that science doesn't know everything. That's true, but scientists have some idea of what they know and what they don't know. Perpetual-motion machines would violate conservation laws that have held up in a wide variety of circumstances. It's conceivable that there's someplace in the universe where conservation laws are violated because hydrogen atoms are popping into existence, but it's very unlikely that conservation laws are violated by some collection of capacitors, conveyor belts, and old mufflers that Uncle Elmo assembles in his garage. Similarly, the point about "no known mechanism" is that these sorts of chemical reactions have been studied intensively for many years under many different conditions. It's kind of like saying there are no known unicorns. We not only haven't seen them, but we have good reason to think that, if they did exist, we would have seen them by now.
• The empirical objection is that, in more than two centuries, homeopaths have failed to come forward with any hypotheses that have been tested and found to hold true. Reproducible results are very important to the scientific method. Given that there have been many tests, it would be expected that some of them, by chance, would suggest a healing value beyond the placebo effect. The overall results of the testing, however, have been more consistent with the hypothesis of rejecting homeopathic claims.

I don't think the lead section (or any other) should assert that homeopathy is bunk, but I think those two points of the criticism are each worth at least a mention in the lead. (This formulation of the skeptical view seems more accurate to me than one that invokes "the scientific method".) The elaboration of these criticisms, along with the elaboration of homeopathic claims and homeopaths' responses to the criticisms, is of course left to the body of the article. JamesMLane 04:49, 4 Jun 2005 (UTC)

Definition of Remedy

According to answers.com

• Remedy - Something, such as medicine or therapy, that relieves pain, cures disease, or corrects a disorder.
  • Since I don't believe that homeopathically treated water does relieve pain, cure disease or correct disorders, I object to the use of this word in the opening paragraph. Jooler 18:14, 4 Jun 2005 (UTC)

A placebo is also a remedy and often work as well as many conventional medicines. You can argue whether or not homeopathy works better than a placebo but you cannot dispute that it works as well as a placebo. In other words that in some cases pain is relieved, diseases cured and disorders corrected. --Lee Hunter 18:50, 4 Jun 2005 (UTC)

that isn't the defintion of a homeopathic remedy though.Geni 19:46, 4 Jun 2005 (UTC)

Conventional medicines are not approved unless they work better than a placebo. Art Carlson 20:46, 2005 Jun 4 (UTC)

That's true (at least in theory) but it doesn't really have anything to do with the point being disputed. Conventional doctors also prescribe placebos. I note that the remedy article indicates that nowadays the word is more typically applied to herbal medicine than pharmaceuticals. --Lee Hunter 22:39, 4 Jun 2005 (UTC)

A placebo is not a remedy. Placebos do not in and of themselves "relieve pain, cure disease, or correct a disorder" - that is the action of the mind. Certainly the use of the word remedy might now more readily apply to herbal concoctions rather than pharmaceuticals. But I still dispute that the word remedy can readily applied to something which I believe that does not actually have any remedial properties whatsover. Jooler 11:13, 5 Jun 2005 (UTC)

You can relieve pain or cure a condition by something you do (taking a vacation) or something you think (mother doesn't hate me after all). The fact that the healing action takes place in the mind is an interesting side note, but doesn't alter the fact that the healing was triggered by taking the little white pill, having psychotherapy or going on holiday. Aside from all this pedantic and semantic stuff, "remedy" is the specific term that homeopaths use. Unless there's a compelling reason, I think we should keep using it. And one final note, homeopaths have millions of satisfied clients like myself, people who will tell you that conventional medicine and other forms of alternative medicine did nothing (or made things worse or caused other problems) whereas homeopathy simply provided a safe, inexpensive and permanent cure. Perhaps, since 'science' says homeopathy can't possibly work, we're all just delusional, but when it comes to deciding whether something is or isn't a "remedy" I think the opinions of the actual patients should count for something. --Lee Hunter 13:24, 5 Jun 2005 (UTC)

That hits the nail on the head. There are millions of people that think homeopathy works because they were sick, they took a homeopathic preparation, and then they were better. A scientist is trained to ask critical questions about this hypothesis. Are there also people who were sick, took a homeopathic preparation, and didn't get better? Are there also people who were sick, didn't take a homeopathic preparation, and got better anyway? How many people were in each of these groups? With what accuracy can I determine these numbers? If more people really do get better after taking a homeopathic preparation, is it the result of something in the pill or something else that happened? Could there be reasons that people say they got better when they really did not? Could an observer sometimes conclude people get better when they really do not? How can I design a study to rule out as many of these possible confusing factors as possible? I don't mean to denigrate the opinions of satisfied customers of homeopathy, but if you are interested in what is really going on, their opinions "count" less than the few good studies which have been made. Art Carlson 14:08, 2005 Jun 5 (UTC)

But you're mixing up several issues here. The question of whether homeopathy performs better or worse than a placebo in clinical trials is one question. Whether "remedy" is the appropriate word for a substance used in homeopathy is another. I recognize that one of the reasons that 'remedy' has fallen out of favor in conventional medicine (in favor of more neutral terms like drugs, pharmaceuticals etc) is that, to a scientist, the word does imply a positive outcome and therefore doesn't lend itself to the world of double-blind studies etc. But whether it actually works better or the same as a placebo has nothing to do with the how the word "remedy" is commonly used in the English language and especially within homeopathy. Even within homeopathy, it's difficult to find the "right" remedy. Sometimes a homeopath will try many remedies and not find one that produces an effect. Even when it obviously doesn't work, the stuff in the bottle is still known, to patient and doctor, as a "remedy". --Lee Hunter 15:11, 5 Jun 2005 (UTC)

You're right, I got sidetracked. I apologize. As to the issue at hand, I personally have no problem with using the word "remedy" in the sense of "intended to remediate". On the other hand, there must be synonyms, maybe "preparation", that would satisfy everybody. Art Carlson 20:09, 2005 Jun 5 (UTC)

With regard to the use of the word remedy I think my re-wording now satisfies my concern, it no longer states that homeopathic products are remedies, merely that homeopaths consider them remedies. With regard to the other issue, Art makes the point eloquently, do homeopaths really want to know what is going on when someone reports the success of a homeopathic treatment, or are they just in the business of quakery and exploiting people. Sine scientia ars nihil est. Jooler 16:27, 5 Jun 2005 (UTC)

A good homeopath works like a good doctor. Both are focused on helping the patient improve. They operate from different models, have different standards of wellness and use different bodies of knowledge but the focus is on whether the patient is better or worse. Bad doctors, and I've seen a few of those, ignore the patient and rely on the 'science' even in the face of contrary reports from the patient. You like to characterize homeopaths as near criminals exploiting the gullible. There are definitely many poor homeopaths out there (and given the lack of standards there are unquestionably more bad homeopaths than there are bad doctors) but there are also many who are sincere, modest and extremely knowledgable (quite a few are also MDs). The best homeopaths (I'd count my own homeopath in that group) have skills of observation and analysis which are superior to any doctor I've met. So, in answer to your question, homeopaths do want to know what is really going on when a patient reports improvement. Like any good doctor, they don't much care whether or not the improvement fits the current state of science, only whether it is real and whether it is lasting. One key difference though, is that homeopaths are completely focused on deep and lasting cures. For example, if someone has a recurring rash a regular doctor will generally prescribe an ointment or antibiotics to control the symptoms. A homeopath, on the other hand, would find that approach appalling and wouldn't be satisfied until they found a "remedy", something that solved the problem permanently. --Lee Hunter 17:30, 5 Jun 2005 (UTC)

evidence?Geni 20:46, 5 Jun 2005 (UTC)

Of what? --Lee Hunter 21:57, 5 Jun 2005 (UTC)

of suppression, that homeopaths can cure anything beyond the placebo effect, that genus epidemicus is not part of homeopathy and that individulisation is real. For your stament to be correct you need to be able to provide evidence for all of the above.

Your choice of a rash as an example is an interesting one. A rash is very often a symptom of something more profound, like an allergy or a deficiency or an emotional problem or a more chronic illness. As a senior software designer working with more junior colleagues I often find that that they try to patch up a bug by working around it, for example if a function consistently returns a value one less than it should (the off by one error is not uncommon in software) they might simply add 1 to the result. This is a simplification, but it illustrates the point. My response to this kind of patching up is to state -- "you are treating the symptoms and not the disease". If a doctor prescribes ointments etc.. without looking more deeply at the reasons for the condition, then they are also guilty of treating the symptoms and not the disease. For a homeopath, a patient has a cough, what does he do? - he prescribes a solution made (before dilution) from a substance that would induce coughing. The supposed "holistic" approach of homeopaths is a myth. Even if they were prescribing products that were known to cure they are only aiming to treat the symptoms, just like a bad doctor. I find your bald statement "there are unquestionably more bad homeopaths than there are bad doctors" very illuminating. Jooler 22:10, 5 Jun 2005 (UTC)

I'm afraid you only have the most superficial idea of how homeopathy works. In your view: "This stuff makes people cough so if we dilute it, it will fix a cough." That is not what happens at all. It's almost unavoidable that people get that impression if their only exposure to homeopathy is through articles like this, but it's completely wrong. There are probably hundreds of remedies that include "cough" as just one of hundreds of data points. And then the cough is only piece of a huge picture that covers the patient. The homeopath (a good one anyway) will spend a long time getting to know the patient on a deep level (often going back to childhood), organize the patient's story into themes and patterns, sift through a staggering quantity of information and sort through thousands of remedies to try and find the one that exactly fits the patient like a cryptographic key. If he or she hits the right one, not only the cough will improve, but anything else that is wrong with the patient should also disappear (sometimes it takes a combination of remedies over time). Contrast that with the way your family doctor works. "Gee that's a nasty cough! Here try this new cough suppressant the Bristol-Myers guy dropped off this morning along with tickets to that big conference in Thailand!" --Lee Hunter 22:43, 5 Jun 2005 (UTC)

Nice strawman about conventional medicine. Now a homeopath may do all that but we know that hahnemann was prescibeing sulphur an incredibly large amount of the time[1]. If you ever look through a list of what most homeopaths prescribe it's the same remedies again and again arnica, nux vom, the so called polycrests. There may be thousands of homeopathic remedies but I doubt more than 30 or so are used with any real regularity (I doubt it is even that high but no matter).11:03, 6 Jun 2005 (UTC)

Speaking of strawmen, why do you always go back 250 years to try and disprove what homeopathy is doing today? There are still a few homeopaths who think that Hahnemann is the last word but, like everything else in the world, most have moved on. One could also say that conventional medicine is rubbish because at the time of Hahnemann surgeons didn't wash their hands. Its nonsensical. Regarding your doubts about how many remedies are commonly used, I can assure you that a good homeopath does work from a repertoire of thousands of remedies and will frequently prescribe the so called small remedies. I myself was given one of the more esoteric, recently proved remedies and the effect was striking. Perhaps it was still a 'placebo' but it makes me wonder why doctors and other forms of alternative medicine weren't able to provide such an amazing "placebos". Of course, the more well-known remedies are no doubt prescribed more frequently, but that's hardly informative. Your average doctor prescribes antibiotics for conditions that he knows aren't treatable by antibiotics. It doesn't mean antibiotics don't have their place or that lesser known pharmaceuticals are not used. --Lee Hunter 11:31, 6 Jun 2005 (UTC)

it is no longer considered ethical for doctors to prescribe placebos. Trying to get hold of treament records for modern homeopaths is difficult without resorting to theft.Geni 17:44, 6 Jun 2005 (UTC)

A 'remedy' in Homoeopathy is a potentized medicine - prepared as Hahnemann describes - that has been prescribed correctly and is therefore acting curatively. Unless and until it is applied in this way it remains a potentized medicine. Unsigned comment by user 62.53.0.87. brenneman^(t)(c) 03:04, 15 July 2005 (UTC)

No that woruld be the clasical defintion which is far from universal.Geni 10:34, 10 Jun 2005 (UTC)

NPOV tag

What points are open that require the NPOV tag (which, if I follow correctly was introduced by Geni), as opposed to the normal editorial differences? Art Carlson 20:58, 2005 Jun 4 (UTC)

none that I know of. You may want to ask Leifern or Rudi.Geni 21:29, 4 Jun 2005 (UTC)

Sorry, I've been off for a while, but you guys seem to have been having a good discussion. For now, the lead part seems a very workable draft as we develop the body of the article. --Rudi 01:54, 8 Jun 2005 (UTC)

Some specific controlled studies and clinical trials

Hello, Geni,
Don't you think you might have compressed some useful information away in the introductory sentences to this section?(diff) I don't really know what your objection is, either, since your reference [2] seems to be to a pay site. At least I just get the cryptic title ("Malathion A and B esterases of mouse liver-I") of a paper from 1975. I agree that my paragraph is probably out of place here, but I think it should be incorporated into the section 4.2 Lack of evidence for therapeutic efficacy, rather than deleted.
More generally, I would like to find and briefly analyze the best 2 or 3 studies in each of these categories and/or the best 2 or 3 positive studies. What I am after is a well-informed and transparent basis for judging the quality of the evidence. This task is not too easy because the proponents of homeopathy don't seem to agree on what their best evidence is. I hope you can help with this.
Art Carlson 13:01, 2005 Jun 15 (UTC)

Try here for a reference[3]. The problem is that the over the last few years there has bene a lot of negative reaseach into homeopathy. Before then the balance probably in favor of homeopathy although the quality of studies ranged between poor and appalling. The link was not to the most complete list of studies of homeopathy around (in fact it was to an extreamly short list of studies. The true total is around 100). In terms of anaylising studies there are only three studies that I know of that follow sciencific protocols and full homeopathic ones (although there are a few more that follow the methods of homeopathy that are often used in practice). Two of them are already in the article the third is [4] Geni 13:44, 15 Jun 2005 (UTC)

Thanks a lot, Geni. Your first reference is very enlightening. It leaves me with the question of what to do with this section. I created it originally as a catch-all for details that were cluttering the main article when I was reorganizing it. I thought it would be useful either, like I said, to give an informed basis for evaluating the quality of the evidence, or to answer proponents who say, Well what about the study by so-and-so proving such-and-such? After reading the review cited, I have grown faint of heart at the idea of in any way doing justice to the quality and quantity of recent research. And we haven't heard much from proponents pushing any particular research results. (I am left with the impression that they are not that interested in science. I guess otherwise they would not be proponents.) So the radical question is: Do we need this section at all? We can put a few uncompromising summary statements into the "skeptical" sections and link to the review for those interested in the details. What do you think? What do our resident homeopaths think? Art Carlson 08:53, 2005 Jun 16 (UTC)

homeopaths do have some interest in science but most of them are not to0 worried about it. Danna ullman was probably the last to really try and make the case that homeopathy had been proved scientificaly and his book is getting dated. Other than that there is the reseach funded by boiron into ultra molecular trials. Since we have no idea about publication bias in this area (although there are reasons to suspect it is quite high) it is a bit difficult to come to solid conclusions in this about this work.Geni 12:22, 16 Jun 2005 (UTC)

Is the scientific case strong enough to move the section on "Lack of evidence for therapeutic efficacy" from "The skeptical view of homeopathy" into its own section? Or to rename "The skeptical view of homeopathy" to "The scientific status of homeopathy"? (And moving "Homeopathy not completely harmless" someplace else.) Art Carlson 11:47, 2005 Jun 17 (UTC)

we don't write articles from a scientific POV.Geni 12:00, 17 Jun 2005 (UTC)

The information on the studies is "scientific" and leads one to be "skeptical" of homeopathy. The question is, which label is more accurate, more informative, or more neutral? I certainly won't press the point. That would be spoiling for a fight. I do plan to throw out the section on "Some specific ..." and move the introductory citation of Renan and Rodrigues to "The skeptical view of homeopathy" if I don't hear any objections soon. Art Carlson 12:10, 2005 Jun 17 (UTC)

A possible mechanism

I added this section as a rebuttal to the oft-repeated skeptical position that "there is no possible mechanism for homeopathy". While this is true re. potentization/water memory etc, it is not at all the case re. the Law of Similars. The burgeoning field of "Darwinian medicine" is based on a realization that symptons can sometimes be a "good thing", rather than something to be treated.

Isofar as the Law of Similars advocates substances that induce specific symptoms, Darwinian medicine provides a clear mechanism for the Law of Similars.

"Darwinian medicine" says that the human body has developed responses that help it cure itself. It seems to me, if I have an infection, my body knows (has evolved to maximize its fitness for survival) how much fever I need. If I take something to raise my fever further, I can only make things worse - to the extent you think "Dawinian medicine" can make serious predictions. Art Carlson 14:49, 2005 Jun 23 (UTC)

Would that our adaptive immune system were so perfect. Often it does not "recognise" that a response is needed, or gives an insufficiently strong response. For instance, a common treatment for plantar warts is to simply abrade the affected area, provoking an immune response that clears up the problem. Othertimes the system gives an over-vigorous response to a non-life threatening situation, and the immune response itself becomes a threat. Evolution is not perfect. If it was, we wouldn't need doctors and medicines. Fever was simply one (uncontroversial) example of an adaptive response. There are many others.Joncolvin 29 June 2005 04:35 (UTC)

Right. So in those cases where evolution has produced a too weak response, homeopathy (law of similars) should help. And in those cases where evolution has produced a too strong response, allopathy should help. And there is no plausible reason to expect that similars help more often than dissimilars. Art Carlson 2005 June 29 08:56 (UTC)

Sure. It's certainly a mistake to regard the so-called "law" of similars as a "law". It is hardly infallible, and likely to be wrong more often than right. But it is possible (likely even) that Hanrehann stumbled on a way to induce immune responses, and then over-generalized and formalized it into a law. He may have also stumbled onto hormesis, and then again taken it beyond its limit of applicability. Both these (interesting) possibilities are ignored by an over-skeptical approach that insists that there can be "no conceivable basis for homeopathy". It is even possible that homepathy might be dragged into the realm of science if these two mechanisms are appreciated (which would require discarding most of what is now known as homeopathy).Joncolvin 1 July 2005 04:46 (UTC)

Your insert states what appears to be your opinion that "there is a plausible (though unproven) potential mechanism". My opinion is to the contrary. The mechanism you describe is not plausible, because of the negligibly small quantities of any active ingredient in a typical homeopathic remedy.

I'm not going to edit your insert by adding my opinion that this theory is absurd. My opinion doesn't matter -- but neither does yours. I'm deleting the whole section. If you want to restore it, provide a citation to some notable spokesperson who says it, and attribute it to that spokesperson rather than stating it as a fact. JamesMLane 07:43, 20 Jun 2005 (UTC)

Did you actually read the section before deleting it? It specifically states that the mechanism is for the Law of Similars, not Potentiatization, so your objection (negligibly small quantities) is entirely baseless. And the section clearly states that it is a *plauible* mechanism, not a proven one. Unless you can provide a good argument as to why this mechanism is unplausible (since it is prima-facia highly plausible), your objection is merely dogmatic. I'm restoring the section; if you want to delete it, say why the mechanism is implausible (and try and avoid using a straw man this time). Since you insist on a "authority", mechanism will be attributed to Dana Ulman, MPH. http://www.homeopathic.com/articles/intro/immune_system.php JColvin, 22 Jun 2005

You apparently don't have much experience with Wikipedia. We try to focus on ideas and we avoid personal attacks. Given that my comment on this talk page quoted part of the passage verbatim, it was unnecessarily snide of you to ask whether I had read the passage. You can express your disagreement without such inflammatory phrasing. To give the obvious answer to your question, though: Yes, I did read it before deleting it. Let's assume hypothetically that St. Fraudswort herb causes fever. Let's further assume hypothetically that the misnamed "Law of Similars" (actually, the "Wild and Unsubstantiated but Potentially Lucrative Conjecture of Similars") is completely true, and that an appropriate dose of St. Fraudswort will therefore cure a fever. It remains true that this is not a plausible mechanism by which actual homeopathic "remedies" could work, because the dilutions are so great that most of the patients are not actually receiving any St. Fraudswort, or are receiving a negligibly small amount. You might as well say that a solution of St. Fraudswort, whether diluted or undiluted, will cure headaches, because hokumweed causes headaches and like cures like. The "Law of Similars" can't apply unless, at a minimum, the patient is receiving a substance similar to what causes the symptom.

Furthermore, it's not my burden to prove that the mechanism is implausible. I'm not saying that the encyclopedia should assert, as a matter of fact, that the purported mechanism is impossible (although it is). Our NPOV policy precludes the flat assertion that it's plausible or implausible. That's why I "insist on a 'authority'" -- because I follow the policy. We can report an opinion on a disputed subject, provided we make clear that it is an opinion, and whose.

For now, I'll recast the subsection in accordance with Wikipedia rules. Longer term, I'm not sure it belongs in the article, whether attributed or not, and even if it's kept it should probably be somewhere else. JamesMLane 19:42, 22 Jun 2005 (UTC)

If you (JColvin) read the section on "Lack of a mechanism", you know that it refers only to the Law of Infinitesimals, not to the Law of Similars. It is true that the latter is not as crassly at odds with science as the first. Is there a good reason for including a counter argument to an objection that nobody makes? Or can you cite someone arguing that "there is no possible mechanism for the Law of Similars"? If we want to include more detail on the Law of Similars, then it belongs somewhere else, probably in the section so titled. And then we would have to include a bit about the difficulty of knowing just what the "Law" is supposed to be saying, and about the fact that there are more exceptions than applications of it. I will delete the section again. If you like, you can reinsert it under "The law of similars" and I will edit it there. Art Carlson 19:54, 2005 Jun 22 (UTC)

Ok, reinserted in section (Law of similars). Please refer to the final sentence of the section on Lack of mechanism; "Even if a homeopathic preparation somehow preserves information from the original substances, there is absolutely no plausible mechanism by which that should effect a cure."; this implies that there is no mechanism for Law of Similars. Similarly, "While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required .. ", does not qualify the lack of mechanism to merely the Law of Infinitesimals. If this section indeed relates *only* to the Law of Infinitesimals, then I suggest this final sentence be removed (I also note that this sentence is a flat assertion lacking authority, contra the wiki rule mentioned by James above), and that the relevance of the section be explicated (perhaps by changing the title to "Lack of a mechanism for Law of Infinitesimals), and editing the other sentence quoted above.

Since homeopathy skeptics usually claim merely that "there is no mechanism for homeopathy" without explicitly qualifying the objection only to Law of Infinitesimals, I think it is valuable to reference a possible (IMHO plausible), albeit unproven mechanism.

Since the new subsection (Possible Mechanism) merely relates to a *potential* mechanism, and notes that the mechanism is hardly foolproof (ie. substance could cause damage), an exhaustive list of exceptions does not seem warranted.

Re. (JamesMLane objecion); again, this mechanism applies *only* to law of similars. It has no bearing on debate as to quantity of active ingredient (although I would note that many retail homeopathic remedies are not merely distilled water, but contain varying amounts of active ingredient). JColvin 2005 Jun 22

active ingredient? botulism A toxin is about the only thing that can have an effect even at the relitavly low potency 6X.Geni 02:26, 23 Jun 2005 (UTC)

Not true. 6X corresponds to ppm. Endocrine disruptors, hormone mimics, dioxin etc are active at ppb. http://californiaagriculture.ucop.edu/0204JA/briefs.html

no since we are dealing with aquious solutions ppm is 1 mg/dm³ . Now if the mother tinctures were at 1 mole (they are unlikely to be anything near that) and the molicules wieghed 100 daltons then we are already down to 0.1 ppm. Now we know that the solubility of this molicules isn't very high (big molicules never are) and the mother tinctures tend to be of a pretty low concentration so if you think you are breaking the PPB mark I sugest you do some more reseach into how homeopathic remedies are in fact made. we will deal with grafting (wich destories your case completely) latter.Geni 03:10, 23 Jun 2005 (UTC)

If you want to argue that most homeopathic remedies are pure distilled water and function on placebo alone, I won't disagree. Just don't throw out the baby (rationale for law of similars) with the distilled water.Joncolvin 05:06, 23 Jun 2005 (UTC)

Thee "rationale" is not consistant with our knowlage of the immune system and desease.Geni 12:19, 23 Jun 2005 (UTC)

Google "darwinian + medicine" (eg. http://www.people.virginia.edu/~rjh9u/darwmed.html). Then tell me how this mechanism is inconsistent.Joncolvin 1 July 2005 04:44 (UTC)

At this point in history it makes no sense to argue for a mechanism of homeopathy based on low but not submolecular dilutions. Sub-molecular dilutions are regularly used and any useful explanation for homeopathy must account for their effect through non-chemical means (chemistry in the narrow sense of chemical reactions). There has been much research in the area lately, which is both hard to keep up with because it is spread ver several scientific disciplines and very advanced scientifically - probably only accessible to professional scientists versed in quantum mechanics and physical chemistry - so the following is just a lay perspective on the matter. From what I gather there is evidence from research unrelated to homeopathy that the clumping of water is not random in the liquid state, and that moreover when it is combined with alcohol (molecules of the two substances cluster with its own and each other non-randomly); these clumps are called "clathrates," a term which seems to have several denotations depending on the field in which it's used. Because the degrees of freedom of such arrangement are very many, the capability of information storage within such a system is potentially very high, and arguably represents a "plausible mechanism." Moreover, hydrogen bonding which is a phenomenon that's very pronounced in water, seems to "spread" in solution (a veyr non-technical description) and may represent a "plausible" mechanism for communicating the structure of the remedy to the water it comes into contact with on the mucus membranes it first encounters when ingested. As for stuff like hormesis, the existence of the phenomenon at chemical levels is no evidence for its persistence sub-molecularly. However, may it be that hormesis and ppb chemical effects such as endocirne disruptors are due in part to non-chemical effects that come into play? In any case, I think that the law of similars has to make sense in terms of a mechanism. But the law of similars can be supported empirically in the absence of a mechanism, as well. It's true, though, that it's not a law in most senses of the term in use nowadays in philoosphy of science. It is more akin to a "postulate": a foundational hypothesis/axiom that is considered true through its usefulness to a discipline (for example, Schrodinger's equation proves its usefulness through the predictions and technological advancements of quantum mechanics, but isn't itself backed by a plausible mechanism. Moreover, the law of similars has a circularity in it: it is only through successful clinical response that one can determine "similarity", so the law cannot be refuted empirically. Nevertheless, it is an extraordinarily useful concept for any practicing homeopath. A similar case in science is the idea of survival of teh fittest in biology: by definition those that survive are the fittest. This is the basis for some scientists' claim that evolutionary biology is not a science. But nevertheless survival of the fittest is a crucial idea in evolutionary biology! I think the law of similar is of a similar nature. Davidnortman 14:00, 25 Jun 2005 (UTC)

Frankly, this supposedly plausible mechanism strikes me as grasping at straws. So water molecules sometimes arrange themselves differently. Is there evidence that a given quantity of water, with no other substances present, can have radically different physiologic effects, depending on which arrangement is in place? Also, the article says that there are 3000 homeopathic prescriptions that homeopaths have accepted based on their "provings". So, uh, are there 3000 different arrangements of water molecules, each with a distinct effect, and each capable of being produced by exposing the water to a comparatively tiny quantity of a substance? And, even if we swallow hard and assume all that to be true, it's at best a mechanism for homeopathic efficacy, but not for the "Law of Similars". Is there any reason that each and every one of these 3000 configurations of water has an effect that's opposite to the effect of the substance that produced it? That seems, if anything, more implausible than the rest of it. I'm not saying the water would have the same effect as the substance; I'm saying that, even if we assume there are distinct effects, there's no reason there should be any correlation, positive or negative, between those effects and how the causative structure was generated in the water.

The theory of evolution is generally accepted because it's the best explanation for a whole range of data (speciation, the fossil record, the presence of suboptimal forms in organisms). The details of the operation of natural selection aren't known exactly; contemporary scientists differ with several aspects of Darwin's theory when it comes to specifying the mechanism. The basic theory of random mutation plus natural selection is, however, widely accepted because of its explanatory power. I can't help but be suspicious of a system of thought that doesn't try to explain widely observed data, but only a few imprecisely recorded observations of one man, and then, having come into existence that way, goes rummaging through all the data generated by scientists, looking for examples that might be seen to have sort of similarity with the theory, at least by someone predisposed to see that. JamesMLane 28 June 2005 10:23 (UTC)

Of course I am grasping at straws - that's the nature of early-stage scientific enquiry! Neither of us can say what's possible and what's impossible: we need to experiment. Scientists do experiments even in the absence of any "plausible" mechanism (but if you prefer "probable," "possible," or "proposed" that's all the same, just semantics). That water molecules arrange themselves non-randonly is not at all trivial: for instance, I asked a chemisty prof I was studying with back when I took some undergrad chemistry (a well-known professor in physical chemistry working with molecular arrangement) about homeopathy and his objection was precisely that according to his understanding water molecules could not but arrange themselves randomly in the liquid state (more specifically, that any non-random arrangement would degenerate "within picoseconds"). And a friend of mine who is a top-notch physicist/electronic engineer who knows the innards of quantum mechanics finds the subject really interesting and full of fascinating possibilities that he himself would love to study (even though he is indifferent to homeopathy per se), rather than an absurdity unworthy of consideration. Your objections are similar in approach to those made by opponents of evolution (since you brought up the subject): "It makes no sense that such complex organisms have formed through random events," etc. - Who are we to prejudge plausibility? If you believe that we have the right to do so, then you admit that science is a social enterprise. And if so then we have to consider issues such as dominant paradigms, funding of research (you think homeopathy is not worth much attention but I think it should have much more attention, and that's just two random people's opinion!), etc., which if included could weaken the skeptical argument overall (because there are demonstrable social pressures against destabilizing the current paradigm). Regarding specifically to your comment about having a configuration that is opposite to those of the substance that produced it: no, that opposite effect has something to do with the organism response to the "signal," not with the signal itself - it's somewhere else in the chain of mechanism-of-action. For other issues see my reply to Art below (specifically, if you object to the above mechanism that what do you propose should be the design of the homeopathic research enterprise? Should we begin with clinical proof even though it is well know that clinical studies are interpreted in light of mechanistic plausibility? With mechanism of action (but how can we do it if hypotheses are regarded as prima facie implausible)? Does the whole thing have to make sense at once (but what experiment do you propose that will test all facets of the problem all at once)?)

Finally, homeopathy is not the observation of one man alone. Many observations are verifed, many are carried across generations without verification: this happens in all human affairs. I am myself prima facie suspicious of observations I haven't made myself in homeopathy, and there are numerous clinical phenomena I haven't yet observed - that's the nature of any healthy system, preferable to the dogmatism that neither conventional medicine nor classical homeopathy are immune from. Homeopathy is so complex because it tries to take account of all phenomena that people experience. There's no such thing in homeopathy as "it's in your head," "there is no diagnosis for your condition," etc. Medicine seems consistent because it boxes out large swaths of human experience and physical evidence: How come all my the physical tension I experience is confined to the left side of my body? How come one person says his ruptured disk is "killing me," another that "it feels like I'm frozen," another has no local sensation but reports that "I cannot go to work and my family depends on me"? I find these differences the most fascinating thing about life and disease, and homeopathy is equipped to deal with them. Another approach is to dismiss these differences as irrelevant, but that won't do for patients that are bothered not by the slipped disk per se but one of the quoted things above. And then there are the many patients I deal with who have no medical problem but still don't function well in life - I comfortably call these "spiritual issues," without necessary religious connotations implied. In conventional medicine people are viewed through pre-existing categories into which they are force-fit. In homeopathy the ideal is to discover the pure experience from observable signs to "deepest" symptoms as they are and try to fit a substance to it. What's fascinating is that once in a while the description of a patient and the words on a page about a substance (obviously written prior) agree remarkably (I can send you an such an example case histroy if you're interested) - what to me is another channel of evidence for homeopathy. Why this approach should yield any results is the deepest mystery of homeopathy (and perhaps the only thorough definition for the law of similars, though this would probably be a minority view within homeopathy: "That there is a resemblance of pattern [whatever this means - i.e. open to explication and refinement] between disease states and substances when prepared homeopathically which can be exploited to restore health."), far more confusing than anything to do with mechanism-of-action concerns. And I submit that many a skeptic who will take the time to spend a week observing a good homeopath in actual clinical work without prejudice will come out at least confused, if not strangely impressed. Homeopathy cannot be understood from a book any more than can, say, playing piano (nor can medicine, which doesn't function as neatly as in the books... but I've mentioned this already before).
Davidnortman 28 June 2005 17:53 (UTC)

We're getting a bit far afield from the purpose of this talk page. It's not for the discussion of homeopathy; it's for the discussion of the article. The article should not say that there is a plausible mechanism. It shouldn't even endorse homeopathic positions that are disputed by critics. For example, the current version says, "The lack of definite predictions by the law of similars makes it difficult to test scientifically." This is the eternal cry of the pseudoscientist: The reason that testing doesn't confirm the theory isn't that the theory is bogus, it's just that it's hard to test. Well, I think it's pretty easy to test a supposed remedy scientifically. If homeopaths make the argument that some particular theory is difficult to test, then we can include their assertion, along with a summary of their reasoning, all clearly identified as an opinion (usually, coming from a named source with a supporting citation).

I didn't write that the efficacy of potentized remedies is hard to test but that the law of similars is hard to test. "The lack of definite predictions" is a somewhat milder way of saying "unfalsifiable", i.e. pseudoscientific. I'm on your side! Art Carlson 2005 June 29 09:07 (UTC)

I'm not suggesting that homeopaths have to test the whole thing at once. Pick a few of your most reliable cures and subject them to double-blind testing. An experienced homeopath examines the patient, asks whatever questions s/he pleases about the patient's symptoms, spiritual health, and anything else under the sun, and selects a homeopathic remedy. Half the patients get the prescribed remedy while the other half get a placebo. The patients don't know which they're getting, and their condition after the treatment is evaluated by someone who's also ignorant. Why is that not a fair test? (Incidentally, homeopaths could themselves employ similar methods to compare the effectiveness of different potentizations.) The article can state the undisputed facts that this kind of testing is regarded as the best possible evidence by the scientific establishment, and that the scientific establishment's evaluation of the data from such tests is that the data are best explained by the hypothesis that homeopathic theories are completely wrong, but that, with enough tests, chance will throw up a few that appear to show the opposite, and that publication bias will make those results more accessible. If some homeopaths have stated an objection to that view, I have no problem with including a report of their opinions, too, as long as the article doesn't endorse them. Thus, I'm not trying to exclude "multiple perspectives". I don't think we need to get into Kuhn's views, any more than we need to elaborate on the CSICOP axiom that "Extraordinary claims require extraordinary proof."

Now, continuing the process that I criticized, of going far afield, but I can't let this point go by: Your analogy between my argument and the opponents of evolution misses the key point that I made. With evolution, the data came first, and a theory was accepted scientifically because it provided the best explanation of the data. It's reasonable for science to be more cautious before accepting a paradigm shift like evolution, or homeopathy, or plate tectonics. JamesMLane 29 June 2005 07:35 (UTC)

I find that we do need to discuss things because there are disagreements about facts and we have to educate each other. You seem, for example, to be naive about the scientific enterprise. Do you believe that there is a simple test that will satisfy every critic? Just as an example, Geni has recently posted an objection to Reilly's work because he tested isopathy and not homeopathy (as though proof for isopathy would have no bearing on homeopathy). A test such as you suggest would be objected to by many critics who would not be able to make sense of it within their one-to-one disease-treatment paradigm. So even though you and I might like it, to make a whole study like that would be a gamble because it might just flatly be rejected for this reason - and such a study design is extremely expensive to execute with a sufficient number of people, which brings in the sociological issue. Should the homeoapthic community pull together and come up with the money? I would vote against this for the reason above, as would others who are not as interested as I in scietnific proof of efficacy. The number of tests is as large as the number of critics, and besides clinical work always gets interpreted in light of mechanistic knowledge (this is not a flaw but inherent to statistical design when p-values and other markers of significance are read correctly, as they inevitably incorporate a subjective element) - so many, including myself, would argue that there's no point for further clinical work (except to confuse the issue) until more is understood about mechanism-of action. I would like to point out that both PhatRita and Leifern, neither of whom seems to be a homeopath but who have a background in scientific studies (I infer this from their bios) hold more nuanced positions that don't flatly accept or reject "homeopathy" (whatever than means) but have specific, informed opinions about specific things.
Davidnortman 1 July 2005 14:08 (UTC)

David Nortman removed much of this material, commenting "makes no sense: Aspirin's homeopathic picture has nothing to do with its conventional use and ditto for the rest." I only added this to balance the claim that the law of similars is plausible. If this claim is removed then I do not object to removing "aspirin". This is, however, part of the larger question of whether the law of similars has a life independent of the principles of infinitesimals. Historically it came first, and provings were done with chemically relevant doses, including information from actual poisonings. Even in Hahnemann's liftime, homeopathy moved away from this. If it is now considered irrelevant, then there is no relevance, e.g., in Hahnemann's quinine story. Art Carlson 2005 July 1 16:09 (UTC)

I searched "plausible" in the current article and all contexts talk about implausibility, so I don't see the problem. In any case, the law of similars is not meant be proved in the same way as the issue of infinitsemials: these are completely separate issues requiring a separate approach. Note, though, that if a test were designed to test the law of similars separately (say a repetition of the quinine experiment) then biochemical explanations would be sought and undoubtedly found. This, however, wouldn't prove that the law of similars is invalid, since a biochemical explanation and a homeopathic one can apply concurrently to one phenomenon (besides which in vaccination the same principle is used though again with an emphasis on the immunological explanation). As for testing the validity of the law of similars in sub-molecular dilutions (which combines the two issues), I think the Reilly tests do a pretty good job of it - aetiologic similarity is a simple-enough case to research: simplified but not too much so as to nullify clinical effect; symptom similarity is more difficult because of the skillful interpretation involved and should be left for a later stage (after mechanism of action and clinical effect of sub-molecular dilutions). There is no point in labelling the law of similars as plausible or implausible anywhere, and in fact I would encourage removal of the word wherever it appears unless it is clealry within a clause stating it as this-or-that's opinion. The only fact about the law of similars is that it is a guiding principle of homeopathy; so if homeopathy can be shown to work clinically [with RCTs... hypothetically speaking to everyone's satisfaction!] by using this guiding principle there is no need to be proved separately. I think my explanation of it as not a law but a postulate does the trick by avoiding overstating the case in the first place.
Davidnortman 1 July 2005 19:20 (UTC)

Homeopathy not completely harmless

Zicam regularly contians active ingredents and claims to be homeopathic.Geni 11:58, 22 Jun 2005 (UTC)

Rethinking tone of whole article

I am joining the discussion before introducing any substantial changes. I am a homeopath with an strong interest in philosophy of science. My main concern with the article is that it falls flat on its face by trying to be exegetical and evaluative all at once. Regardless of your individual inclinations for or against homeopathy, the purpose of an encyclopedia entry is to present the subject matter from the perspective of its internal logic. One doesn't, for example, begin an article on Christanity with something like "...is the world's largest religion, notable for its controversial tripartite characterization of God. Moreover, no plausible mechanism for the existence of God has been found." The conrovertiality of homeopathy need not be alluded to until later on (entirely contained within extensive "Skeptical View..." and "Mechanism..." sections) because any semi-intelligent reader will realize along the way that there are 'interesting' features to homeopathy. I would like to request that those interested in the discussion read the following article: http://www.thespiritofhomoeopathy.com/evolution.html which not only provides a superb historical overview of homeopathy (albeit with an over-representation of info on Indian homeopathy, where the article was written), including some recent developments that are controversial even within the homeopathic community, but illustrates how to approach a subject-matter without prejudice, but just describe it for what it is. At the end of the article one isn't compelled to cry out "Wow! Homeopathy is incredible"; rather, one is able to begin evaluating the subject-matter from a position of knowledge. More specifically for our purpose, the arrangement of the article is, I believe, the proper way to arrange the early part of this entry. Only following a similarly comprehensive description should the various complexities be dealt with. Could we discuss the issue I brought up and create a fresh outline before returning to the text? It may require several passes just to arrange the sections correctly. Davidnortman 05:55, 23 Jun 2005 (UTC)

The article you reference has some interesting historical material, though an awful lot of stuff I found uninteresting. More to the point, its POV is thoroughly homeopathic, not in any way a paragon of encyclopedic style. Art Carlson 08:44, 2005 Jun 23 (UTC)

I assume you are referring to the overview/preface? I think it is kosher to refer to controversy here; the preface should give a quick summary of the entire article, and controvery is definitely part of the parcel for this subject. The analogy with religion is not entirely fair; homeopathy claims to be a science, Christianity does not. Most people are well aware that religions are controversial; this might not be the case for those new to homeopathy. Joncolvin 05:42, 23 Jun 2005 (UTC)

There should be a single reference to controversy toward the end of the introduction, alluding to the fact that following the description of homeopathy will be critical analysis. As of now there are two references which immediately divert the reader away from first understanding homeopathy on its own terms toward evaluating it prematurely. (I find that most people that criticize homeopathy know almsot nothing about it, and I presume that the purpose of a critical perspective here is to produce people who are critical of homeopathy once having learned about it.) A proper article consists of exegesis followed by critique, in this order and with clear separation between the two. For example, the use of submolecular dilutions should be in the exegesis, and a criticism of the same in the critical section later on, not immediately following the description so as to interrupt the still-incomplete narrative flow. The overriding concern should be for clear rhetoric (in the classical sense of the term) which permits the reader to make proper judgments. Davidnortman 06:06, 23 Jun 2005 (UTC)

I don't agree with your assertion that "the purpose of an encyclopedia entry is to present the subject matter from the perspective of its internal logic." Rather, the purpose is to summarize all the important information about a subject, including the information from perspectives that don't accept its "internal logic". Consider the article on The Protocols of the Elders of Zion, which begins by describing it as "a fraudulent document". Bear in mind that many of us think a similarly harsh opening would be entirely accurate for homeopathy (although I'd be more inclined to invoke quackery rather than fraud).

As for what goes into the lead section, we don't assume that everyone's going to read the entire article. One purpose of the lead section is to summarize the article for the benefit of people who want only about one minute's worth of information on the subject. Another purpose is to help the reader decide whether to read the entire article. For both purposes, it's important to note early on that homeopathy is not accepted by scientists. JamesMLane 18:06, 23 Jun 2005 (UTC)

I do not disagree, though the analogy to the Protocols... is not accurate because (a) the Protocols... was not written in good faith whereas homeopaths for the most part act in good faith (b) a book can easily be read so an article on needs to focus on its context - whereas homeopathy cannot be understood so straightforwardly so preliminary explication must be done, and (c) believing a book like the Protocols... can and has caused harm, whereas the same cannot be said of homeopathy: even if occasional harm is done by homeopathy (mostly as you would likely agree due to omission, i.e. the withholding of conventional medical care), this cannot compare on a per-person-treated basis with the acknowledged harm done through conventional medicine, and most people's experience of homeopathy is positive (whereas most skeptics have not had a bad experience with it). Moreover, skeptics generally operate from the assumption that any harm from alternative medicine is unacceptable, instead of measuring it relatively to the very high rates of harm from conventional medicine. In any case, I am not at all offering to obscure the controversial aspect of homeopathy. For example, following a few sentences of 'straight presentation' of homeopathic principles, I would be glad to see a whole sentence, perhaps something like: "From its inception homeopathy has been steeped in controversy, both due to its opposition to the prevailing medical practice of the day (both 200 years ago and now), but especially due to its frequent use of 'ultra-dilute' preparations in which the purported medicinal substane is no longer present, which therefore cannot have a medicinal effect according to known scientific principles." - This is actually stronger and more informative and historically correct than immediately pointing out only one aspect of the controvertiality of homeopathy in the first sentence (although I would want to counter somewhere later on that "known scientific principles" are not as crisp as publicly marketed science makes them to be). The point is that the first few sentences have to say what homeopathy is as millions of people who use it, and thousand of homeopaths who practice it, both in good faith, experience it. Davidnortman 04:34, 24 Jun 2005 (UTC)

The homeopathic reply to the skeptical view

I don't like this organization. It looks like a return to the "Is so! Is not!" format of earlier versions (see Talk:Homeopathy/Archive_3#Reorganization). I also have a number of specific objections to the content. That is not to say that this section doesn't need work, but I would like to see comments from other editors here before accepting your reorganization. On the content, your tenor is that case studies and clinical experience are an acceptable alternative to RCTs. This is demonstrably false. They might be better than nothing, but they are known to be subject to systematic errors. Art Carlson 08:35, 2005 Jun 24 (UTC)

The idea is to present arguments that homeopths involved in research make; the dialectical structure is intended actually to balance the section and not make it too pro-homeopathy, i.e. every argument in favour of the homeopathic view is critiqued. (I think this is what you mean by "To avoid pro and con ad infinitum, this third section would report the skeptics rebuttal of the rebuttal as well." from the archived discussion. This indeed seems to be an efficient way of covering many small points, and capping the argument. As for alternatives to RCTs: I have done much research into the matter and found out that there is much criticism of the simplistic hierarchy in evidence-based medicine (RCTs are better than observational studies are better than clinical evidence) coming from highest-echelon epidemiological experts. EBM has been embraced widely by administrators and legislators because it provides an excellent way of making sense of things in a large-scale medical infrastructure; but its scientific merits are completely unproven (I challenge anyone to provide proof for the validity of EBM). There is, for example, evidence that observational studies (a) agree with RCTs of the same treatments and (b) show a much narrower spread of results (so that an individual observational study can be trusted more than an individual RCT because of the propensity of the latter to show opposite results to the aggregated trend). For more on this topic you can see a long essay I recently completed, with many references (contact me if you'd like a PDF copy of specific ones), on the topic of evidence-based medicine. RCTs are have become the gold-standard for rationalist reasons (logical arguments saying that they are most immune to bias) but empirical evidence shows that they may not be any more precise than other methods. Moreover, many people are not concerned about whether homeopathy is placebo but whether homeopathy is clinically effective, and this latter question is very rigorously answerable using observational studies that compare homeopathy to known effective treatments. If homeopathy cannot be proven to be non-placebo but can be proven to be clinically effective then it is perfectly rational to use it for treatment, as this is an independent issue from the implications of such behaviour on teh future of scientific medicine (for instance it is rational to get into your car to drive somewhere even if that leads to the destruction of the ozone layer). Davidnortman 17:07, 24 Jun 2005 (UTC)

If your last point is referring to the idea that the placebo effect can be deliberately exploited to help the patient, I agree. It's my understanding that, even leaving homeopathy out of the picture, doctors sometimes use a remedy that they think will benefit the patient only a little or not at all, and they tout it highly so that the patient will think it's more effective than the evidence indicates. I don't understand your reference to "the future of scientific medicine", though. The placebo effect is part of scientific medicine, in that its existence has been established to the satisfaction of scientists. I assume that homeopaths and scientists could agree that some patients will get better if given a supposed remedy that is pure water, with no memory of any prior substances it's contacted. Is there something else here that I'm missing? JamesMLane 18:18, 24 Jun 2005 (UTC)

What I was referring to is that the question of the validity of homeopathy is multifaceted, not only constrained to the issue of proof for medicinal activity of homeopathic solutions, but also to do with ultimate clinical efficacy, validity of its theory of disease, etc. This is why I would like this section to be expanded. For example, in my frequent dealings with fmaily physicians I find that at this point most are more concerned about clinical efficacy than scientific validty. For their purpose observational studies comparing treatments are more useful. Next, what I was referring to with regard to the future of scientific medicine is that if homeopathy is demonstrated as clinically more effective than conventional treatment for some ailment (what can be done rigorously through observational studies) then the only legitimate argument the skeptic can make against its use is that such an approach to medicine will be damaging in the long term. It would not be rational in this situation to say that homeopathy shouldn't be used because its efficacy beyond placebo hasn't been proven. In any case, I am not trying to have you or Art agree with this view; all I am saying is that this is a view that is held by enough researchers (in homeopathy and conventional medicine) and can therefore be invoked as part of a reply to a skeptical position. I am not suggesting to put it down as fact but as relevant opinion in teh appropriate section. Davidnortman 18:41, 24 Jun 2005 (UTC)

I think you're setting up a straw man. The "skeptical position" is not necessarily skeptical of the clinical efficacy of anything that's touted as effective by the practitioner. In fact, if there were no cases in which such a treatment were effective, that observation would represent an anomaly that would have to be explained, because it would contradict the current understanding of the placebo effect. It's quite consistent with science to say that someone who believes in homeopathy might sleep better if given a homeopathic prescription for a sleep aid, and yet to say at the same time that the skeptics who publicly took huge overdoses of such treatments were in no danger of so much as drowsiness, let alone death, because for them there was no placebo effect. When, if ever, a physician should deliberately prescribe a remedy that he or she knows to have no objective efficacy, thereby hoping to bamboozle the patient for the patient's own good, seems to me to be a question of medical ethics that's beyond the scope of this article. JamesMLane 19:26, 24 Jun 2005 (UTC)

We are still misunderstanding each other, I'm afraid. I'll try again: The skeptical position is multifaceted. Some people (you among them) are concerned with whether homeopathy is anything more than placebo, whether it is plausible mechanistically, etc. Other people, however, especially in the field of actual medical practice whether as patients or doctors, are more concerned with whether homeopathy can be of help in teh clinical context. They treat it as a black box and don't care much for what's inside. This latter position is rarely discussed in popular skeptical literature because the majority of 'active' skeptics are not medical practitioners. All I am saying is that one response to skeptics of your inclination (I'm labelling just for simplicity's sake... my apologies!) is to point out that your concern is not shared by all skeptics of homeopathy. Some are simply skeptical of its clinical efficacy and would accept homeopathy (concretely speaking, in the case e.g. of many family practitioners, feel justified to recommend homeopathy to their patients as an alternative if it were demonstrated through observational trials to be better than a conventional treatment). So one of my proposed replies to the skeptical position simply points out that in many relevant people's opinion questions of mechanism of action and placebo are secondary to the clinical efficacy question. This is not something that you will read about in the Skeptical Enquirer which takes a scientist's perspective but only find through engaging in the health-care system or exposure to technical literature of primary care, for example. The practice of medicine (even at its most scietnific) is very different from the simplistic picture of it that most people hear about. My aim, therefore, in expanding this section is make the article go deeper than most evaluations of alternative medicines that are done from a detached academic perspective that's one remove from clinical reality, becuase medicine is a practical endeavour. Of course I might need help in having what I want to say come across, but I think this approach is desirable in principle. Finally, I should clarify in reply to the comment opening this section that 'observational studies' are not case studies. They are non-placebo-controlled, statistical investigations of clinical treatments done on a sufficient number of people to produce statistically significant results. They can be used to determine treatment efficacy in an absolute sense or in comparison to other treatments, but do not determine which fraction of the treatment effect is due to placebo. Davidnortman 04:27, 25 Jun 2005 (UTC)

I am attached to the present organization because I created it and because it is so much better than what was there before. Still, we might be able to do better. (The question of whether it is better to collect all the pro arguments in one section and the cons in another, or better to treat the pros and cons of each aspect in a separate section, is also being discussed at de:Diskussion:Homöopathie. The current consensus there is in favor of organizing the article by content, not by pro and con.) May I submit the following for discussion:

Reorganize the contents of sections 3-5 (The appeal of homeopathy, The skeptical view of homeopathy, and The applicability of traditional scientific procedures) into a section on "Efficacy", with subsections "Patient satisfaction", "Clinical efficacy as a whole", "Efficacy of potentized remedies". The first section would cover the fact that many people like homeopathy, partly because they perceive that it is effective, but also for other reasons, like the feeling that they are treated and understood "as a whole person", because they find conventional doctors arrogant, and because they are afraid of the side effects of conventional drugs. The next section would address the question of the extent to which homeopathy works in practice. The scientific evidence on this point is weak in both directions. Homeopathic treatment could be effective even if the remedies have no effect. In addition to the placebo effect, homeopaths often recommend healthy changes in life style and often use conventional therapy in parallel. The last section is for the question dear to my heart of whether homeopathy really works, that is, whether there is any demonstable effect of highly potentized remedies that is different from distilled water (or alcohol or sugar). We could slip the discussion of a mechanism and its lack into this last part.

Would this structure be more logical and/or more NPOV? Art Carlson 2005 June 28 08:29 (UTC)

I think the exact organization is not that important and can be adjusted at any time. But since, I guess, the main issues are the actual individual arguments, it may be easier to handle them if indeed they are grouped by topic with all pro and con arguments within each section. The problem with this design, though, is that some topics are related and so are better treated as a group... but overall I'm fine with your suggestion.

Where the issues are, then, are the following: To me the foremost thing is clinical efficacy (and not "perceived clinical efficacy" since the same can be said of any therapy), whereas you are mainly concerned with physical efficacy (for lack of a better term), so both views should be brought out. Second, we are using "homeopathy" in two senses here, as a remedy effect and as a system, so that should be brought out; third is the issue of how to interpret the current scientific evidence: my position is that there is sufficient material to believe that there is an anomaly, and yours is presumably the opposite, to which I suggest that we leave out interpretation of available evidence entirely, instead providing references to several books on both sides of the debate, since any quotation would be selective (or to balance the current quote with cautiously positive ones from very prestigious journals such as The Lancet and British Medical Journal); the deepest issue is one for all of us to think about, as it has not been adressed by either side: What does sufficient evidence for homeopathy consist of? Very strong clinical evidenc of efficacy for one condition? For 10 conditions? For 1 remedy? For 10 remedies? For all combinations of remedies and diseases? Only if there is a mechanism of action? Mechanism for water storage sufficient? Or mechanism of transmission into organism? The reason I am asking is that scientific studies are optimized for answering specific questions. What I've seen so far is that a study demosntrating a clinical effect is dismissed because of no mechanism of action, a study on cells (which is more relevant to the mechanism question) is dismissed because there is no clinical relevance, an NMR study is dismissed because it doesn't explain transmission to biological organism. My point is that the debate about whether there is sufficient evidence is as much philosophical as scientific (and so we disagree because of interpretation of relevance of data rather than because of data), so this fact should be brought out. But this (I now realize) brings us right back to the more pro-con design, where two difference philosophical positions (interpretations of the same data) are represented. Whereas in your design I don't see how we can adequately deal with this aspect of the difference of opinion, which I see as the greatest common denominator. Using my design we could invoke Kuhn (since he says that different paradigms are largely unreconcilable) and have sections entitles "The skeptical paradigm" and "The homeopathic paradigm". You may not agree with Kuhn but that is better than looking at homeopathy strictly through a positivist perspective wherein there is no room for multiple perspectives. Let me know what you think.
Davidnortman 28 June 2005 15:50 (UTC)

Tweaks and Fixes

I would like to draw attention to a few points I would want to fix, but would like some approval before I change it. I am also new to wikipedia so please forgive any mistakes or etiquette problems I make. Firstly in the introduction - I would like to mention the name of the publication that Hahnemann wrote - the Organon of the Healing Art. In fact there were about 6 or 7 versions (with different names too). In the law of infitesimals section, clarification on what higher and lower potencies actually are - whethere high potency is more dilute or has more molecules. This may be obvious for you and I, but for people who want to find out what homeopathy is it may be confusing. Also clarification of what LM actually is. I am a medical student with a keen interest (skeptical) in homeopathy and it took me about 6 months researching into homeopathy to discover its a roman numeral. Also in the same section I think it would be a prudent idea to link the avagadro number ealier - I know it's mentioned later on but I still think that it is such an important point that it needs reiteration. In the homeopathy around the world section - totally totally wrong. Just because the British monarchs use homeopathy does NOT mean its population have taken the idea home. To be brutally honest, that is a very...American... view of Britain - not everyone sips tea at 4 and chews on their butter scones. It is certainly not as popular in Britain as it is in France or Germany. Hahnemann lived his final years in France, and was popular with the nobles there. Therefore the art of homeopathy has taken root there. In fact the idea did not hold in Britain until the late 19thC. The ENGLISH (not british) have never really took up the idea that much, but the Scottish have. This is especially true in the medical profession - homeopathy is a branch that most med students can learn and attain competence in France and Germany as an option, but is non existant in Britain - you have to contact the society of medical homeopathy to get a competence in medical homeopathy certificate and that requires study outside of medical school. Compare the number of doctors with homeopathy competence between Britain and France - thousands against tens of thousands. In the appeal with homeoapthy section - dissaffection with the establishment - this is a very contraversial point. Some research does show that ALTERNATIVE medicine's rise in popularity is due to dissatisfaction with conventional medicine but some research also shows that Comp/Alt med is truly a case of complementation. I'll dig up the research cases and let you decide. For now I think that this point is not proven as it is possibly based on anecdotal evidence. The lack of evidence section in the skeptical view part - I'm speechless - the entirety of god knows how many years of research on homeopathy discarded, and in its place, ONE article in a low ranking journal deciding efficacy (if you're going to judge homeopathy please at least quote one from either the leading journal on Comp/Alt med - ie the journal of alt comp medicine OR one of the four major medical journals - JAMA, BMJ, Lancet, and NEJM). I think that is wrong. Check out the Cochrane Collaboration for all the work they have done on homeopathy and by well trained SKEPTICS of homeopathy. (The cochrane collaboration is an extremely reliable international medical authority) They have lots of examples of homeopathy working for individual conditions. I think it would be wrong to flush all of homeopathy down the drain, but instead focus on a case by case rate. The reviews quoted seem are the only ones that seem to view homeopathy negatively. There are some high quality reviews available on the lancet and other journals which seem to describe homeopathy as above placebo. I feel it is strange that they were not included. Somewhat of a sieve like evidence base? I will find these. The quoting of an article - there are specific ways of writing the refernce list at the end. Variation from different journals vary but consistency is the key. Here is a commonly used one: Author Surname Initial, Second author surname initial et al. (year) "TITLE OF JOURNAL ARTICLE", JOURNAL NAME; Volume(issue number): pages

General vocabulary - this seems to be aimed at a mature audience with an interest in science and may wish to pursue further reading in the subject. Therefore I think the following words or ideas should be introduced and properly explained: mother tincture, and just generally the process of dilution ultradilute/ultramolecular (past the avagadro limit) some basic evidence based medicine - the idea of meta-analysis, systematic review and randomised, controlled and placebo.

Lastly, in response to the claims of mechanism for potentisation - there is considerable evidence out there that I think we should present in a separate section like Mechanism of Action or something like that. This was described by member Davidnortman and quickly dismissed by member JamesMLane. I think you should try to read some of the literature out there. Although I am personally skeptical too, there is a great deal of EXPERIMENTAL evidence which does seem to prove otherwise. Again, I will find the evidence from my project as soon as I can. From my memory this is the way clathrates support eater memory: the clathrates of water and alcohol form around the original tincture molecules. The succussion process shakes off the core tincture molecule and the clathrate that was previously around this molecule collapses in on itself and forms a new SECOND clathrate or a core clathrate. The original tincture molecule is then free to form a second clathrate. The literature was obviously written by a person with a background in physics or physical chemistry. He postulates that there is a PHYSICAL not CHEMICAL difference between the different potencies and so PHYSICAL and not CHEMICAL tests are effective. In this model, two points can be made - that more potentisation increases the number of core clathrates, and that succussion is essential to shake off the molecule in the centre of the clathrate. Another experiment found that heating the water above a certain temperature, i think it was 35°C, affects the physical properties of the water(the temperature that homeopathic drugs should not be kept above at.) They performed a number of physical tests, including NMR, dielectric depolarisation and ultrasound tests which showed a difference between difference solutions of potencies, all ultramolecular. Conttroversial and provocative.

3 points can be made in conclusion (modified from Andrew Vickers) : 1 - there is no mechanism to explain how a medicine chemically indistinguishable from water can have an effect on the body 2 - some mechanisms proposed, but these lack credibility 3 - it is not impossible, however, that water and ultramolecular homeopathic medicine are distinguishable by physical tests. PhatRita 28 June 2005 19:00 (UTC)

I'm glad someone stopped by who is up-to-date on the research. As you seem to have a comprehensive grasp of the material, I would support the inclusion of a section written mainly by you that summarises the current research: providing a few quotes from meta-analyses on both sides (or even all of them to date), a proposed mechanism for each stage of the chain (memory of water, transfer to organism, effect on cells) - I don't see a need for a whole seperate section), and clinical studies, each with brief summaries or quotes of a research example. I think given the importance many people attach to this if you can summarise even as many as 20 studies (good ones on both sides) very compactly then we'll have room for them. All this would be under some neutrally-titled section such as "Scientific study of homeopathy" and would try to present data fairly without evaluating it. Following that could be the sections I am proposing (see discussion immediately above), namely a skeptical evaluation followed by a homeopathic evaluation of reserch data and some philosophical considerations.

The small changes sound good though may be too detailed eventually - include them for now. I agree with you on England (At least from my remote impression, while you seem to be in England), homeopathy is respected officially due to the royal patronage but is still not as popular as in many places in Continental Europe.
Davidnortman 29 June 2005 05:21 (UTC)

Welcome aboard, PhatRita. It sounds like you have a lot to contribute. (Though you shouldn't expect it all to get through the scutiny of your fellow editors.) I am mostly interested in the scientific research on clinical efficacy of potentized remedies. I am not satisfied with the coverage here, but I have neither the background (medical education) nor the resources (medical library) to do it right. Do let me point out that the issue is not the quantity of studies but their quality. Where is a single RCT study that has produced statistically strong evidence for homeopathy and has been independently replicated? Art Carlson 2005 June 29 09:25 (UTC)

I've just been digging my shelves for those research papers and doubt that I can find them, but I do know how to access an NHS e-library so I'll find some reasonably convincing evidence for Art Carlson in time. Regarding your single RCT - I remember a study performed by Dr David Reilly published on the Lancet in 94 - "Reilly's Challenge". It was a particularly rigorous trial which made the editors of the lancet distinctly uncomfortable. The following is the only information I can give you but I doubt you'll get more than an abstract, if that - the Lancet cut off articles before 1996 that are available online.

[Ed](1994) "Reilly's challenge." Lancet; 344: 1585

I'm also cut off from my medical library as I'm no longer at university in Scotland. But down here in England I'll see if I can access the local university medical library. Meanwhile for anyone who wants to quicly catch up on the literature this following article is excellent. It is written by three experts on the CAM world, one of which does practise homeopathy and one acupuncture. It does contain a huge list of very reliable systematic reviews for specific ailments and a list for homeopathy in general.

[5]

oh just found the reilly's challenge editorial

"If Petr Skrabanek were alive, we could expect to be chided for publishing this week's paper by Reilly et al. The basis for scientific thinking, he declared, is rational scepticism: "Irrational scepticism is characterised by an inability to accept the category of the absurd."' And what could be more absurd than the notion that a substance is therapeutically active in dilutions so great that the patient is unlikely to receive a single molecule of it? Reilly and his homoeopathic co-workers gave such substances to patients with allergic asthma and detected activity--even though hardly the degree of activity that would impress a respiratory allopathist. They invite us to choose between two interpretations of this activity: either there is something amiss with the clinical trial as conventionally conducted (theirs was done with exceptional rigour); or the effects of homoeopathic immunotherapy differ from those of placebo. Yes, the dilution principle of homoeopathy is absurd; so the reason for any therapeutic effect presumably lies elsewhere. But no, carefully done work of this sort should not be denied the attention of Lancet readers. How will they respond to Reilly's challenge? And will Reilly now treat us to a comparison of high dilutions and low?

The Lancet "

taken from the Lancet, 1994

PhatRita 29 June 2005 13:42 (UTC)

Thanks. What has been published about that study in the last ten years? I also found The Evidence for Homoeopathy by Reilly in 2003. I hope it will give me a picture of the current state of the debate, at least from his perspective. Art Carlson 2005 June 29 13:50 (UTC)

Just got around to reading it. What a disappointment. Only 2.5 of the 15 pages really deals with the evidence, and after reading it I don't feel I have any better view of the research than I did before (which wasn't great). At several places he makes highly questionable statements. This article is not the way to convert non-choir members like me. Art Carlson 2005 July 4 19:13 (UTC)

Reilly's work is flawed for a number of reasons. He claims that studies with very different protocols are repitions and poor diagnosis of those takeing part means that it is imposible to reach legit conclusions from his results. Finaily he is not technicaly testing homeopathy but Isopathy.Geni 30 June 2005 23:39 (UTC)

??? - I am frankly baffled by these off-the-cuff comments! Reilly can be equally credited with saying that recent work claimed as repetition of his is not (see http://bmj.bmjjournals.com/cgi/eletters/324/7336/520). Whose judgement are you referring to when claiming that his diagnoses were poor? Finally, if isopathy is validated isn't it obvious that it has at least some bearing on homeopathy, considering that isopathy and homeopathy are both notable for prescribing ultra-dilute preparations and that this is what most skeptics object to in homeopathy? (On the other hand, disproof of isopathy doesn't necessarily disprove classical homeopathy because of the significant methodological differences.) - See my comments elsewhere on this page re the fact that it is impossible to satisfy the critics as a whole, so I don't know what your suggestion would be.
Davidnortman 1 July 2005 14:19 (UTC)

factual accuracy

ok then Leifern what factual errors are there in the artilce. If yoiu think there are errors list them here and we will see what can be done to correct them.Geni 30 June 2005 23:43 (UTC)

• I have done this before. Homeopathy is, for example, not notable for prescribing remedies without chemically active ingredients. The description is misleading. All you have to do is look at my many previous attempts, you'll see my point. It is only because Geni keeps reverting and deleting entire sections that you disagree with. --Leifern July 1, 2005 01:18 (UTC)

in fact it is notable for that since it is homeopathies only really original feature. Every other element of homeopathy exists in some other system or other. Remedies dilited beyond the point where they can contain chemicaly active ingredents is a feature only found in homeopathy and homeopathy derived systems (isopathy, bach flower remedies and the like). If we look at the other features of homeopathy that most homeopaths seem to accept then like cures like is just sympathetic magic and the the vital force is just rehashed vitaism certianly nothing unusal there.Geni 1 July 2005 01:26 (UTC)

It is acceptable to say that Homeopathy doesn't have a scientific basis, and that it is notable for prescribing remedies without chemically active ingredients. It is of a piece with many other (especially New Age) "disciplines" which don't have directly verifiable mechanisms, yet many people believe in them wholeheartedly. Humans are funny creatures, and will respond to the most obscure things for no apparent reason, and this, IMO, is the actual explanation for Homeopathy's continued popularity. Fire Star 1 July 2005 04:55 (UTC)

Geni and Fire Star - you guys are professing views that are aggressively ignorant. Pick 10 random introductions or primers to homeopathy, and you'll see that the way you want this presented bears no similarity to how homeopaths present their work. In truth, homeopathy is distinct from what they call allopathic medicine because they (claim to) observe that the effect of a remedy increases in reverse proportion to its concentration, even to the point where there is only a small chance that any active chemical ingredient is left. Pay close attention to the point that they view this as an observable fact - the notion of "vital energy" (which very few homeopaths use) is an attempt at explaining why, but it isn't part of the theory. I've gone over this before with Geni, but he simply ignores the points. Until there is an honest, constructive, and collaborative attempt at making this into something different than a polemic to promote Geni's views, the article remains disputed for its lack of factual accuracy and neutrality. --Leifern July 1, 2005 12:52 (UTC)

You want the tag because you dispute the factual accuracy of the statement that "Homeopathy is ... notable for prescribing remedies without chemically active ingredients"? I guess you are not disputing that homeopathy prescribes such remedies, only whether this fact is "notable". Could I ask what definition of "notable" you are applying? Would you like to suggest an alternate word? Art Carlson 2005 July 1 14:15 (UTC)

Can we agree to keep the tag based on the principle that it is better present when not needed (false-positive) than not when needed (false-negative)? I am not too concerned with the current "notable..." phrase but second Leifern's tagging, for example because of a concern I brought up about a week ago that the ocntrovertial nature of homeopathy should not be alluded to twice in the introduction becase it diverts the issue from exegesis to premature evaluation; I suggested a comprehensive sentence that highlighted rather than obscured the controvertiallity issue but without this diversion. There are many little things in the article that were written from a lay perspective of those who have read a bit about homeopathy and think that they know a lot, and unless those are repaired there is no reason to remove the tag. Besides, it is reasonable to have this tag on indefinitely due to the wide disagreement on the topic. This is not a bad thing as one thing can be stated with certainty: that the issue of homeopathy is not as simple as it looks, so each reader will need both critical faculties and research time to make sense of it.
Davidnortman 1 July 2005 14:28 (UTC)

I'm generous regarding a NPOV tag. What I object to is Leifern adding a tag saying that there are factual disputes without listing those disputes on the talk page. Art Carlson 2005 July 1 20:17 (UTC)

The talk page is for editors to reach consensus on the article, how it is labelled, etc. The disagreements can be settled here by consensus. Stating my views above is to that end. We don't want this to become a puff piece for Homeopathy any more than we want to say that it is definitely worthless trash. There is a neutral style of writing that will do this. There should be a brief overview that mentions what Homeopathy is, that it is popular, that many others are sceptical. We should then in the main body of the article objectively report on how Homeopathy's practitioners promote it (and did promote it) without endorsing their promotion, how it is perceived by other professionals who work in the medical field (where expanding the sceptical bits introduced in the first overview make sense) and by the public without endorsing those perceptions. This is pretty much what we have already, IMO. Again, it is another thing like astrology that shouldn't work at all, yet it has endured for many years. Who knows? That isn't the issue. We have resolved similar, thornier disputes before. Fire Star 1 July 2005 15:58 (UTC)

Wow I've been away for a day and this topic has a NPOV tag again. I think it would be wise to say that the level of neutrality of which Fire Star is suggesting is almost unattainable. Just look over the ABC of complementary medicine series, on homeopathy

ABC of comp. medicine:homeopathy

Even though I think the author has performed a good job on being neutral, there are still pro and anti homeopaths raging it out on the rapid responses. The moral of this story, boys and girls? You can't please everyone, especially when your audience is a worldwide one. Even if editorial here reach agreement it would not be to the complete satisfaction of each individual editor, never mind to the rabid anti and pro homeopathists out there. PhatRita 1 July 2005 17:27 (UTC)

I went ahead and took some initiative and added a section on the scientific research so far in homeopathy. I feel that giving results of scientific studies is closer to the truth than interpreting the science because interpretation usually has some bias. I also felt the previous version had a distinct anti-homeopathic stance. I took off the hormesis seciton in the theory of infitesimals and also the lack of evidence part in the skeptical views. To be honest, there is more evidence out there in favour of homeopathy than against. Perhaps that section needs axing. the scientific section now has two parts - clinical trials and potential mechanisms. I also revamped the references section too. Will probably have to do some fine trimming and such, assuming the page doesn't get reverted within 2 seconds flat. PhatRita 4 July 2005 00:00 (UTC)

I'm not very happy with your edits. Then again, I was not ecstatic about the way it was before. No time for a detailed anaylis/re-edit, but the two things that strike me right away are

1. The confusing organization. We now have 3 The appeal of homeopathy / 4 The skeptical view of homeopathy / 5 The homeopathic reply to the skeptical view / 6 Scientific evidence so far. That is, pro/con/pro(+con)/both. Either the scientific evidence should be incorporated into the previous three sections, or everything should be put into one big "scientific evidence" section.
2. The clathrates. This all sounds like gobbledygook to me. At the very least the criticisms have to be included, but I don't think the speculation is worth the space.

Anyway, thank you for joining the game. Art Carlson 2005 July 4 07:39 (UTC)

To be honest I wasn't too happy about it either. I feel speculation is the only solid part of science about homeopathy that you can write. The previous edit had very selective evidence against homeopathy. In fact the whole thing felt like it was written by an anti homeopath. Definitely not neutral. This edit may have toned down that sentiment. My hope is that by putting down what we do know about homeopathy and the most convincing arguments, we can remain neutral. I'll make another edit to meet your points which I do agree with. Regarding the clathrates - it would be a lot better if there were some diagrams. I'll start drawing some tomorrow and will try and simplify it a little although it is fundamentally a little complex.

I think the fist point on organisation can be corrected by just almagamating sections 3,4,5 & 7 into just a separate pro and anti homeopathy section. This would give the reader a first glimpse into the homeopathic argument and then lead them to the scientific research to let them decide. A much fairer and more neutral postition?

PhatRita 4 July 2005 11:10 (UTC)

How about the following: A large section titled "The scientific validity of homeopathy" where first an overview of the difficulties is given, plus some neutral references such as the one I recently included from Linde et al 2001. This can be followed by a tabular (2-column) format with sub-topics such as "mechanism of action" with one side saying "no plausible..." and the other giving the clathrates hypothesis (preferably with references to papers rather than an extended explanation); pharmacological classical dose response curve vs hormesis; "clinical evidence" with a listing of meta-analyses for and against in their respective side; "Clinical efficacy" with one side maintaining the ultimate importance of RCTs and the other the ultimate importance of clinical results; "The appeal of homeopathy" with one side sayying it attracts people with magic-like ideas and the other than homeoapths actually listen to people, etc. I could do the initial reformatting if I hear positive feedback. This format will be at once pro-con and issue-by-issue, combining the two competing formats thus far proposed.
Davidnortman 4 July 2005 15:11 (UTC)

go for it. PhatRita 6 July 2005 17:02 (UTC)

Looking at this two-column format, I think it's a bad idea. We can present each subject area, with what's undisputed and then each side's contention as to the disputed points, in narrative form, without the separate columns. JamesMLane 7 July 2005 15:51 (UTC)

My first impression is negative, too. It is harder to read than a narrative and the format forces an impression of balance - in every individual point! - that may not be justified by the data. Art Carlson 2005 July 7 17:01 (UTC)

The problem with presenting each subject area is that there are advantages and disadvatages both to doing it (i) point-by-point and (ii) one side then the other, and we cannot decide which is better. My idea may be visually more confusing but has more potential conceptually. As for undisputed material: that can be removed from the 2-cloumn area to an appropriate place such as the introduction to the Scientific validity... section. The whole thing can be improved visually in time, say by putting a line break above each 3rd-level heading. As for balance: the idea is to balance each point with a reply. The strength of the arguments will determine which side "wins" in every case. The presentation, rather, suggests two parallel narratives/interpretations of more-or-less the same observations (i.e. at their best skeptics don't deny lack of clinical efficacy, homeopaths don't deny lack of mechanism or clear support from clinical studies, etc.). But the reality is that there is a lot more interesting scientific data on homeopathy than both of you are familiar with - it really takes months of work to dig up enough of it to form an impression. Just as an example, there are several studies done over the years on cells which repeatedly show an irregular oscillatory response to homeopathic preparations as potency is raised - like a sinusoidal graph when plotted with a (10 or 100) logarithmic x-axis representing mathematically idealized concentration of solute (i.e. as if concentration continues to decrease smoothly beyond Avogadro's) - alternately stimulating some factor or suppressing it. This pattern is not at all discussed anywhere in the canonical homeopathic litrature (which rather claims a deepening of action on whole organisms with increased potency), so there is reason to consider this a real, anomalous effect rather than a concoction of the homeopathic community. The NPOV on the matter of homeopathy is to present the best of the two narratives without interpretation (e.g. if a pro-then con format is chosen, then why not con-then-pro? - the order affects the tone significantly!). Here we only have to decide which one's right and which one's left... If you're concerned about the two sides being perceived as equal then why not work on the points to strengthen them, and also throw in replies-to-the-replies in the homeopathic side, as is already the case on a couple of occasions. Let me know your thoughts.
Davidnortman 8 July 2005 18:31 (UTC)

Let me know your thoughts. I agree with JamesMLane and Art Carlson - the two-column format needs to go. Wikipedia states: "Wikipedia attempts to be an encyclopedia and not a complete compilation of human knowledge." I recognize that there will be some debate as to what is essential information for any article, but my opinion is that listing numerous studies to support one side or the other is not appropriate for this forum. I think there should be enough information to give the reader general knowledge that the practice is not accepted by everyone, briefly state a few reasons why that is, then let the reader research the finer points elsewhere. Edwardian 8 July 2005 19:25 (UTC)

I'm fine with having less detail overall, but many insist on providing a thorough critique of homeopathy from a scientific perspective. As it stands now there is tons of detail about scientific issues, about the presumed magical origins of homeopathy - speculative, as there is a clear historical record of the experimentation that took place in arriving at infinitesimal doses, etc. - and too little detail about basics of homeopathy, such as quotations from the Organon to make the reader understand some principles introduced there that still remain valid today in the homeopathic view. But as it stands there naturally needs to be a response to the scientific critique or else the article has a clear mainstream-scientific POV (a position that's based on generic objections and therefore inadequate, as two points have to come across: that homeopathy doesn't make sense scientifically and is therefore potentially invalid; and conversely that potentially homeopathy presents a challenge to conventional science). Moreover, your concern seems to be about the amount of detail rather than the structure per se - there is no more material now than beforehand - so can be dealt with by refining the text and boiling the points down.
Davidnortman 9 July 2005 14:47 (UTC)

I'm concerned about the amount of detail AND the structure sucks. Edwardian

Re: user:Edwardian - let the reader research the finer points elsewhere? Where on the net can you find a reliable and impartial site concerning homeopathy? There isn't one that is easily found. And the reader would not know if it was neutral or not. I dont want to debate the nature of wikipedia's existence, but isn't this what it is for - the whole truth and nothing but the truth? Cliche aside, perhaps an optional section or even a new entry that describes the research clearly? Ps I disagree with the idea that the possible mechanism should be disregarded due to it being speculation - the controversy surrounds a lack of mechanism. Wouldn't suggesting possible mechanisms therefore add a balance to the argument, as well as add an extra dimension to why homeoapths defend their practise so faithfully?

PhatRita 00:02, 11 July 2005 (UTC)

I think the previous reference to Wikipedia sums up the nature of Wikipedia: "Wikipedia attempts to be an encyclopedia and not a complete compilation of human knowledge." I would interpret that to mean that we’re here to present “nothing but the truth” but not necessarily to present every bit of knowledge about the subject that might be true (if that’s what you mean by “the whole truth"). If we were able to research the “finer points” without the help of Wikipedia, then so could someone else. Regardless of the amount of information (or lack thereof) that is out there on the web, I feel the job of Wikipedians is to present an article that is reliable and impartial, not an extensive reference book that is reliable and impartial.

For example, rather listing study after study that might support or disprove the validity of homeopathy, a simple summary that states something like this, “Some meta-analyses have concluded that there is no significant difference between placebo and homeopathy [1] [2] [3] while others have found an effect above placebo [4] [5] [6] [7]; however, advocates and critics of homeopathy continue to debate the validity of the studies.”, would be more encyclopedic and streamiline the article. Failing that, I would be in favor of a new entry that looks at the research more in depth, as you have suggested. Edwardian 21:35, 11 July 2005 (UTC)

I agree with you that your proposed format is more streamlined and readable. At the same time the subject matter is so convoluted that a simple article is no more helpful than the myriad "introductions to homeopathy" available in print and electronically. I think we're on track, with your help as you clearly have a good sense of style, and following the eventual conversion of in-line references to footnotes, to streamlining while prviding basic summary (simply listing the meta-analyses does not add knowledge to the reader, as an internet search will bring those up fairly quickly). The early Theory section can be shortened significantly, something I hope to work on next.
Davidnortman 01:24, 12 July 2005 (UTC)

Suggested changes in the section entitled "Homeopathy and vaccination"

From: "The practice of mainstream medicine that most closely resembles homeopathy is vaccination." To: "To some (or many), homeopathy closely resembles the mainstream practice of vaccination." Reason: For those with a basic understanding of immunology, they are nothing alike. Edwardian 08:14, 10 July 2005 (UTC)

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From: "Modern homeopaths view vaccination and homeopathy as fundamentally different." To: "Vaccination and homeopathy are fundamentally different." Reason: Modern homeopaths are not the only ones who view them as fundamentally differernt. (See previous reason.) Edwardian 08:14, 10 July 2005 (UTC)

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From: "Homeopathic critics of vaccination also consider the resemblance to the law of similars to be superficial." To: Delete from this article. Reason: The primary subject heading is entitled "Misconceptions about homeopathy". If homeopathic critics of vaccination do not have those misconceptions, the statement is unnecessary. Edwardian 08:14, 10 July 2005 (UTC)

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From: "The difference between homeopathy and vaccination is best illustrated by a comparison with nosodes, which are made from active (not deactivated) pathogens, are applied after the onset of a disease to cure it (not before to prevent it), and are administered at zero (not merely low) dosage in a chemical sense." To: Delete from this article, reword and replace in nosodes. Reason: That this statement "best illustrates" the differences is POV. This statement refers to specific differences between vaccinations and nosodes, not the entire practice of homeopathy. The phrase "chemical sense" makes no sense. The active ingredient in a vaccination is not a chemical. Edwardian 08:14, 10 July 2005 (UTC)

Sounds good to me - this section could, as far as I am concerned, be whittled down to one par. of 3-4 sentences. It's not relevant to either side of the debate beyond addressing a question that pops into the mind of many readers.
Davidnortman 22:59, 10 July 2005 (UTC)

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Would anyone object to this rewording of the section? It would streamline the article by cutting the section from 13 sentences in 4 paragraphs to just 1 paragraph of 4 sentences:

"To some, homeopathy, particularly the use of nosodes, resembles the mainstream practice of vaccination in that vaccines contain a small, closely-related dose of the disease against which they are to protect. Hahnemann himself interpreted the introduction of vaccination by Edward Jenner in 1798 as a confirmation of the law of similars. However, to those familiar with (the modern practices of?) homeopathy and immunology, the two practices are are fundamentally different. A vaccine is usually a bacterium or virus whose capability to produce symptoms has deliberately been weakened while still providing enough information to the immune system By preparing the immune system of a healthy organism to meet a future attack by the pathogen, vaccination hopes to prevent disease in contrast to homeopathy's hope which is to cure it.”

If we’ve sufficient explained what homeopathy is previously in the article, then we shouldn’t need to do it again. We should only need to point to how vaccines primarily differ from what was previously mentioned. I feel this summarizes the fundamental difference between the two. Concentration of dosage is certainly one difference (and there are many!), but it is not the fundamental difference nor the primary reason the two are confused. Edwardian 21:49, 11 July 2005 (UTC)

This sounds good enough and better than the previous ramble. One sentence to consider adding at the end is: "The one modern medical therapy that does significantly recalls homeopathy's law of similars is allergen immunotherapy where repeated doses of an allergen, sometimes in extremely low doses, are injected into the body in the hope of desensitizing the patient to it."
Davidnortman 01:17, 12 July 2005 (UTC)

PhatRita's edit on July 14th entitled "small title change" actually revereted the entire change noted above to its previous status. I changed it back. Would appreciate some discussion if someone feels that the wording above is not more appropriate. Edwardian 08:46, 15 July 2005 (UTC)

Plausible mechanisms exist

No citations so it appears to be orginal reseach (ok I have run into homeopaths claiming simular mechanisms on the basis of no evidence but not exactly this one). The mechanismns do not appear plausible and thridy they are not in fact mechanisms of action (hint they have failed to show any mechanism for action within the body).Geni 12:00, 11 July 2005 (UTC)

Issue addressed. May I request that in future you contribute constructively by through editing and requesting references rather than simply deleting a section that multiple others clearly think should be included in some form.
Davidnortman 01:09, 12 July 2005 (UTC)

I didn't see any disscussion agreeing it should be includued. It was clearly original reseach and POV so deleting seemed a logical course of action. Its not like it will even the slightest effect in the long run.Geni 01:42, 12 July 2005 (UTC)

PhatRita has developed the section after presenting the idea and waiting for major objections. Almost immediately above she again repeated her view on the importance of the section. Note that she is a medical student who spent time researching homeopathy rather than a homeopathic fanatic like myself, so she and I are not necessarily in the same camp, yet we both feel the need to include a section that adresses the claim - in our minds arbitrary - that a mechanism is impossible.
Davidnortman 03:42, 12 July 2005 (UTC)

but you have failed to provide a mechanism. Even if we acceept all that silly speculation as true it doesn't explain how this stuff is stored on suggar tablets. it doesn't explain a mechanism of action in the body. It doesn't explain how C,X and LM potencies should differ.Geni 10:50, 12 July 2005 (UTC)

please note that I am "he" and not "she" - the name comes from a very long and complex story going back a few years that I won't go into. Yes, Geni, it is true that there is no mechanism to explain how the stuff works in a body, but it is not impossible - no research has been allocated to this regard, as scientists just have no idea where to start. To say it as impossible would be too premature and close minded. The studies I have quoted (not highly reliable) have presented with the view that water is distinguishable physcially from homeopathic solutions but that alone is a significant step in its own right and should be worth mentioning. To write it off altogether as speculation just because one final, although important, link has not been found, is very right wing. Also, can I just say that there is a lot of conflicting information between homeopaths anyway - you cannot take everyone's word as being the final say in homeopathy. PhatRita 13:08, 12 July 2005 (UTC)

you know one of these days I'm going to find out how many of these studies boiron are funding. Untill then there is not reason not to think that the results are due to publication bias (ok I can show that some of the studies are flawed as well but that is a different matter)Geni 15:36, 12 July 2005 (UTC)

Alternatively (no pun intended), some would say that if one asserts there is reason to think the results are due to publication bias, then the burden of proof is on the person making the assertion. Edwardian 15:41, 12 July 2005 (UTC)

The experiments are dead easy to run compared to a clinical trial. Boiron does spend quite a bit on them each year and people are unlikely to publish failed results. The lack of replication is particularly telling here. Of course there arn't enough of the things yet to do a funnel plot but give it time.Geni

It is scientifically irresponsible to reject something just because not all steps of it are understood. Witness the rejection of evolutionary theory by creationists on the grounds that there is no evidence for this-or-that step in the evolution of this-or-that creature. It's true that there are many evidential holes, much speculation required, and that one of those lacunae may one day prove fatal to evolution. But most scientists don't reject the theory at large for that reason alone. (This is also why I objected to your removal of the section instead of requesting references - ideas are built-up stepwise, not overnight.) Now as for action in the body: I think this is far less implausible than the primary issue of information storage. See http://www.lsbu.ac.uk/water/ where you can read about the nature of hydrogen bonding, namely that the structure can "spread" through those water quite remotely - I don't know enough physical chemistry for this but don't see why this would be highly controversial. As for biological action in the body once the information gets through from remedy to mucuous membrane to whole body, again, this is not implausible considering that subtle conformational differences in proteins can affect biological function profoundly, and that those conformations are known to be highly sensitive to the temp, pH, etc. of the water-based broth in which they are invariably bathed. Finally, sugar pellets never dry out completely: relative humidity anywhere on earth is always above 0% even in the driest of deserts, and as lactose is sufficiently hydrophilic there is no reason to assume that enough water could not be present to sustain some information-carrying properties. Likewise for "triturations" in which insoluble substances are prepared not in water/alcohol but by grinding in lactose: moisture is picked up from the air that could then serve as the information carrier. This issue to my knowledge has not been researched, but doesn's seem to me a big stumbling block. I could include some of this stuff in the text if you'd like, but I would consider it speculative. Perhaps add something to the section with your reservations.
Davidnortman 15:33, 12 July 2005 (UTC)

nice starwman you have their. incedently as a chemistry stdundent can I say that your speculations don't agree with reality as we know it (structures in water appear to only last for very shor time perious and any that do exist would be desoryed by adding and excess of sucrose).Geni 12:23, 14 July 2005 (UTC)

lets separate between actual speculation, ie- how the remedy works once inside the body, and the proposed and experimented mechanisms for the idea of actual difference between water solutions which are chemically indistinguishable. Yes the research is dodgy at best, and I'll list the referecnes for YOU, yes you, Geni to actually read - it's all inside a book edited by Ernst and Hahn and having sections from all the big cheeses of homeopathic research - Homeopathy: A Critical appraisal. Oxford:Butterworth-Heniemann. However before I go off for another weekend away from the internet, ask yourself this: is the string theory (or M theory or whatever) discredited because it is a hypothesis with limited if non existant solid research? Is it not mentioned somewhere in wikipedia:particle physics because of a lack of convincing studies showing "efficacy"?

NO. Think about the fact that one of the most implausible ideas of medicine in existence (even more so than, say, iridology or radionics), which has fought long and hard to prove itself as efficacious either pragmatically or through proving mechanisms and suddenly, what science once described as impossible is a possiblity once more - homeopathic solutions can be differentiated from just water. However remote this possiblity this is, however poor the research which suggests we must, as responsible scientists look into it and present it as evidence. Even if you can't understand or refuse to believe in it, Geni, other members do and you must present it thru the force of democracy, whatever that is. Good weekend guys

PhatRita 17:08, 15 July 2005 (UTC)

In reply to Geni: You are obviously convinced that there is no way that homeopathy can make sense scientifically. Your last response doesn't address any of my text and just spews empty (not to mention patently hasty) refutations. Again, please engage in constructive discussion. Thanks in advance.
Davidnortman 19:22, 18 July 2005 (UTC)

Correction: at the “clinical trials” section one can read:

“Rodrigues & Moritz (2003) 14 concluded that "ample evidence exists to show that the homeopathic therapy is not scientifically justifiable", because of serious shortcomings in terms of publication bias and lack of methodologically sound trials validating homeopathy. However, the review was published in an obscure Brazilian journal and is not considered as being very high up the evidence pyramid.”

1) The correct citation to my paper is: Almeida RMVR. A critical review of the possible benefits associated with homeopathic medicine. Rev. Hosp. Clin., 2003, 58(6), 324-331.

2)The journal were it was published is indexed in the Index Medicus (MEDLINE), Excerpta Medica (EMBASE), SCIELO, LILACS, Biosciences Information Service, Biological Abstracts (BIOSIS), Chemical Abstract Services Cource Index (CASSI) and Índice de Revista Latino Americana em Ciência (Periódica) – México. Calling it "obscure" is incorrect.

(Anyway I should take as a compliment that this was the only objection to it)

rmvrahtm@hotmail.com