Template talk:Alternative medicine sidebar

Talk:Alternative_medicine#Removal_of_navbox_pages

Related discussion, for the interested. Gråbergs Gråa Sång (talk) 17:03, 19 July 2022 (UTC)

Semi-protected edit request on 5 April 2023

This sidebar paints osteopathy as a pseudoscience and alternative medicine. The entire "This article is part of a series on Alternative medicine" sidebar should be removed as it talks about osteopathy in the same light as other fringe medicine and conspiracy theories that are not substantiated in science. Osteopathic physicians (DOs) are recognized by the same medical boards that recognize allopathic physicians (MDs). Furthermore, there are numerous peer reviewed articles detailing the benefit of OMT (osteopathic manipulative treatment) over placebo AS WELL AS over traditional western medicine. By having this here Wikipedia is promoting the continued marginalization of osteopathic physicians. OMT is also covered my medicare, medicaid and all other major insurance companies because they know that it works, decreases healthcare costs, and they recognize the need for OMT in our healthcare system. It is not an "alternative medicine" or a "pseudoscience" anymore more than allopathic medicine. Please feel free to email me directly at drfischer@manaomana.org if you have any questions/concerns about this edit request and thank you so much for removing this misinformation from your site. DrJacobFischer (talk) 22:50, 5 April 2023 (UTC)

 Not done: it's not clear what changes you want to be made. Feel free to reopen the request if you feel that the sidebar should be nominated for deletion, though you have to make sure that you're active on the project to defend your point of view (don't expect others to email you). M.Bitton (talk) 23:07, 5 April 2023 (UTC)

Hey M.Bitton!

Thanks so much for reviewing my request. Sorry for any miscommunication. The sidebar states that osteopathy is alternative medicine and catagorizes it as pseudoscience. This is inaccurate as OMT is a widely accepted form of medical treatment in the US. It confuses users and makes it seem like it is in the same catagory as fringe medicine and conspiracy theories and this is misleading to users as the science to back it is well substantiated.

Thanks for your help in this! DrJacobFischer (talk) 00:32, 6 April 2023 (UTC)

DrJacobFischer, we have two articles to cover the subject:

1. Osteopathy (alternative medicine)
2. Osteopathic medicine in the United States (mainstream medicine)

Two different things, so now you know. -- Valjean (talk) (PING me) 00:14, 6 April 2023 (UTC)

Hi Valjean!

Sorry if I wasn't clear. Homeopathy is outside my scope of practice and I do not feel qualified to speak on it. Osteopathic medicine in the US is what all other osteopathy world wide is based upon. However the different between osteopaths inside the US vs outside the US is that Osteopaths in the US are also qualified to prescribe medication, perform surgeries, and administer procedures outside of OMT. DrJacobFischer (talk) 00:35, 6 April 2023 (UTC)

Sorry, that was a typo. Now fixed. Osteopathic medicine in the United States is based on osteopathy. It is the modernized version of osteopathy. There are people who still practice the old version, quackery and all, and in that regard they are similar to chiropractic, with pseudoscientific beliefs and claims. Only American osteopaths are licensed and trained in science-based medical practice. Only they have a right to be called a medical doctor. -- Valjean (talk) (PING me) 01:43, 6 April 2023 (UTC)

I have tweaked the article to make clear the difference. -- Valjean (talk) (PING me) 01:51, 6 April 2023 (UTC)

I see your edits. I guess this will have to suffice. I think the point is being missed here but I will just have to conceed to your authority on the topic. I feel like there is still a lot of misinformation here, but I am new, and by your profile you have more points on this site, so I am not going to be able to make a difference on this platform.

Best in your future endeavors. DrJacobFischer (talk) 04:48, 6 April 2023 (UTC)

"Biological terrain assessment" not in correct order?

The list of quackeries seems to be in alphabetical order, but Biological terrain assessment is between Homeopathy and Hydrotherapy. It should be up between Bates method and Black salve, yes?

Also now that I have looked closer, there are a couple of others out of order. So should the list be kept in alphabetical order or is there some other sorting pattern that I'm not seeing? - Wikkiwonkk (talk) 02:30, 13 December 2023 (UTC)

Feel free to fix these things in the template. -- Valjean (talk) (PING me) 04:04, 13 December 2023 (UTC)

Nah, alphabetical order is the intent. Gråbergs Gråa Sång (talk) 12:33, 13 December 2023 (UTC)

Done. - Wikkiwonkk (talk) 05:41, 14 December 2023 (UTC)

Multiple chemical sensitivity

@Valjean, MCS appears in mainstream medical textbooks like Harrison's Principles of Internal Medicine. That's generally a sign that it's not altmed. What's your source for saying that it's altmed?

Remember that altmed means "not conventional". It doesn't mean "the etiology for the symptoms reported by the patients is presently unproven (and probably not what the patients claim)". WhatamIdoing (talk) 16:49, 25 May 2024 (UTC)

It's what's called an "alternative diagnosis", hence why it's in that section of the template. It also happens to be a favorite "diagnosis" in alt med circles and lots of money is made by alt med therapists and fringe doctors and chiropractors based on that dubious "diagnosis". It's in the same class of bogus diagnoses as Chronic Lyme disease. -- Valjean (talk) (PING me) 18:02, 25 May 2024 (UTC)

I don't have access to what Harrison's says, but I did find the following:

"Central to the MCS debate is whether this phenomenon results from a primary emotional response to perceived chemical exposures or from pathological interactions between chemicals and biological systems. Those who believe the latter argue that toxic interactions result in physiological impairment and that subsequent emotional problems derive from such impairment. Distinguishing between psychogenic (emotional) or a toxicodynamic (chemical toxicity) origin is essential to the medical management of an MCS patient. A psychogenic basis requires treatment with appropriate behavioral therapies; in contrast, a belief in a strictly toxicodynamic etiology argues for avoidance and often precludes treatments that address the psychological responses. Current scientific evidence strongly suggests that behavioral or psychogenic explanations predominate for reported MCS symptoms." (Source)

From that, one can see that one can indeed encounter the words and discussions of "MCS", but that doesn't necessarily endorse it as a legitimate diagnosis. Even "Vertebral subluxation", a quack (chiropractic) diagnosis, has an ICD-10 code (as the term is a politically - not scientifically - established diagnosis for the sake of medicare billing), but that doesn't make it medically or scientifically legitimate. It's a phantom diagnosis, supposedly provided to D.D. Palmer in a seance by an MD who had been dead for 50 years. In 1911, Palmer actually discussed making chiropractic a religion, and that would have been more honest than what we have today. The 1911 short letter is interesting. It was found at the bottom of an elevator shaft at the Palmer school in Iowa. B.J. Palmer had a habit of throwing papers and documents into the elevator shaft, and, when found, the pile of papers was pretty deep. It was a treasure trove for Joseph Keating, Jr. Before he died, I used to communicate with Keating, the chief historian of the "profession". He was a wealth of information. He grew up in the profession, but was not a chiropractor himself. He taught chiropractic history at several chiro schools. He was obviously a skeptic and frequently chastised them for their well-organized scams (they have seminars where they teach each other how to more effectively scam their patients), pseudoscientific ideas, and quackeries. -- Valjean (talk) (PING me) 16:56, 26 May 2024 (UTC)

Where are the MEDRS sources saying that it's an alternative diagnosis? WhatamIdoing (talk) 18:38, 25 May 2024 (UTC)

This line of questioning seems related to these:

• Template:Infobox alternative diagnosis
• Category:Alternative medical diagnostic methods
• List of diagnoses characterized as pseudoscience

Note that our methods of categorization don't necessarily need RS for the exact wording. Do we need a meta-discussion of this? If so, where is the best location to do it? Maybe a project? Quack diagnoses is the more pejorative term. -- Valjean (talk) (PING me) 15:43, 26 May 2024 (UTC)

Fwiw, I added that section in 2019 [1], and I called it "Diagnoses", someone changed it later. My thought at the time was something like "Altmed diagnoses". Gråbergs Gråa Sång (talk) 17:32, 26 May 2024 (UTC)

The source you quote above is 25 years old, by a man whose income appears to depend on defending accused polluters in lawsuits. As a method of determining whether MCS is alternative medicine, citing him on what he thinks causes the symptoms is as credible, and as relevant, as citing the most extreme of the other "side" on what they think the cause is. That is, neither of them are good indicators of mainstream medicine, and "what the cause is" has nothing to do with "whether it's altmed" (=the question at hand).

Also: the dominant stories about etiology have changed since the 1990s, and mental health is real health. "It's psychogenic" does not mean "and that makes it altmed". What makes something altmed is whether conventional medicine accepts it, not whether the cause is understood, whether the cause is psychological, or whether it's evidence-based.

It might be helpful if you read the definitions at Wikipedia:Alternative medicine. It's difficult to communicate, especially in a text-only environment, when people use the same word to mean significantly different concepts.

I've looked at the four sources for the MCS entry in List of diagnoses characterized as pseudoscience. So far, they're all past their WP:MEDDATE expiration dates, and here's what I've found in them:

• https://sciencebasedmedicine.org/naturopathy-vs-science-fake-diseases/ mentions MCS in passing as an example of a "fake disease".
• https://pubmed.ncbi.nlm.nih.gov/23642291/ says it's real but controversial. The word pseudoscience does not appear it, and I didn't see anything even remotely similar in the article. In fact, the long sentence at the end of the abstract says more about this subject than the entire rest of the article. (There is full text access in Wikipedia:The Wikipedia Library under Elsevier/ScienceDirect).
• https://sciencebasedmedicine.org/multiple-chemical-sensitivity-separating-facts-from-fiction/ says it is a "fake disease". It also says that the patients, whose suffering is real, are at risk of exploitation by pseudoscience practitioners. It also says that the treatments recommended "recently" (i.e., a decade ago) in Canadian Family Physician are pseudoscientific. The author of the objected-to articles is also the author of the immediately preceding source (PMID 23642291). He (the PMID 23642291 author) recommended the pseudoscientific practice of dental amalgam removal, among other things.
• https://pubmed.ncbi.nlm.nih.gov/10803638/ says it is "controversial". Nothing in the abstract suggests that it has anything to do with pseudoscience. It also ends with these words: "One leading hypothesis suggests that MCS represents a neural sensitization phenomenon, wherein susceptible individuals demonstrate extreme sensitivity to chemicals and odor intolerance due to central nervous system (CNS) sensitization processes. The recent development of an animal model for MCS provides some support for the sensitization hypothesis and may offer evidence for behavioral changes observed in at least a subset of those reporting MCS", which indicates that MCS is not entirely psychogenic. To my knowledge, nobody has ever managed to produce a mouse model for a purely psychogenic illness, and altmed is not in the habit of developing mouse models anyway.

I would think that any evidence-loving person would want to remove PMID 23642291 from that (or any other) article; it does not support the claim and it is written by someone who holds The Wrong™ POV. But what I'm looking for is a couple of credible, MEDRS-compliant sources that actually use words like "Multiple chemical sensitivity is an alternative medicine diagnosis".

I have looked for them. I have not found them. My usual set of filters at PubMed give me zero hits for that claim. This 2021 nursing handbook does not describe it as altmed, and says there are conflicting theories about the cause (physiological vs psychological vs psychological problems caused by physiological damage [which is a thing, as anyone who's worked with stroke patients knows]). This 2023 book on the philosophy of medical diagnoses (page 79) gives MCS as an example among a list of "complex psychological artefacts, often created by the joint efforts of enthusiastic therapists and malleable patients", but does not describe it as altmed. (Some others in the list are Saint Vitus' dance, Gulf War syndrome, and Hysteria#Charcot.) This 2020 book on how to evaluate worker's compensation claims has a multi-page screed against MCS, says that "many" of them "simply" have Reactive airway disease, and the rest have psychological problems, but declines to call it altmed. In fact, it begins with saying that "some" mainstream medical practitioners accept MCS as a real thing, though with an unknown etiology.

If we're going to make a claim that MCS is altmed, we need decent sources for this claim. If we don't have the sources, it needs to be removed. You can think of this as a WP:CHALLENGE: So far, all the MEDRS-compliant sources are on the "not altmed" side, including sources that disagree virulently with the etiological story pushed by the proponents. Where are the sources to support this claim? WhatamIdoing (talk) 18:42, 26 May 2024 (UTC)

I agree that we don't need sources with the exact word. For example, "fake disease" is probably good enough for the List of diagnoses characterized as pseudoscience. But we're approaching the point at which that list entry should probably sound more like "Scott Gavura, a pharmacist who writes for Science-Based Medicine, called MCS a 'fake disease' in 2014".

For this template, as there is no room to explain the context, I think that we should only include entries if the diagnosis is typically considered altmed. So far, even among detractors, I'm not finding that to be the case. Altmed does not appear to be a typical description for MCS. WhatamIdoing (talk) 19:03, 26 May 2024 (UTC)

You need to get away from thinking that MCS is altmed. No, it's an altmed diagnosis, whereas altmed is methods and treatments. MCS is one of several diagnoses most commony associated with altmed practitioners, who are often fringe MDs, Naturopaths, old fashioned Osteopaths, and Chiropractors. They make claims about MCS, convincing their patients/clients that their symptoms are from MCS, so the clients are then convinced they have MCS, often with no objective evidence. Then these altmed practitioners claim their methods can treat MCS. There is a lot of money in that business model. It often prevents sufferers from seeking the proper help and receiving the right diagnosis, because their symptoms might actually be caused by some other, very real and dangerous, cause, a cause not treated by those altmed practitioners. That's the biggest danger of altmed claims.

You write "mental health is real health". Of course it is. That's why I have never trivialized the sufferings of my patients. I have always taken them seriously, but once they are in the claws of these altmed practitioners, it's hard to get the patients to seek proper care and diagnostitic methods.

The mind is a powerful thing, and if we believe something will hurt us, such as what we eat, it will hurt us, at least our belief will make us feel sick or exacerbate our asthma, to pick an example of a disease with a huge psychosomatic aspect for some sufferers. Are these people with MCS, Chronic Lyme disease, etc. "suffering"? Indeed they are, and they deserve to be handled respectfully. Is there a proven physiological mechanism to explain most of their symptoms, often not.

BTW, the age of a source does not automatically mean it's outdated, unless there is some really good stuff that supersedes it. That does happen, but we don't remove sources solely because of age. -- Valjean (talk) (PING me) 00:26, 27 May 2024 (UTC)

I have repeated the searches, this time using "alternative diagnosis". PubMed, zero hits (and, at a glance, most of the non-MCS hits on "alternative diagnosis" are about Differential diagnosis, which is conventional medicine).

At Google Books in the last five years (per WP:MEDDATE), I've got nothing. There is not one book that uses both of these terms on the same page. Expanding it to the last ten years, I find one – but it's just another DDx ("The presence of significant objective muscle weakness or frank arthritis should suggest an alternative diagnosis" [2]). The page is about ME/CFS, and mentions MCS only in passing as a possible comorbidity or more relevant diagnosis.

At Google Scholar, I get 11 hits in the last five years, two of which are instantly excluded because they're talking about autobiographical works rather than medicine. The rest are some variation on "not explained by an alternative diagnosis" or "consider [an] alternative diagnosis".

Again: Do you have any sources to back up your claim? I have searched. I cannot find any. I believe I'm considered to have above-average search skills, especially for MEDRS-type sources, and I have come up completely empty handed twice now. Wikipedia's job is to summarize verifiable knowledge. Where are the sources in which this knowledge can actually be verified? WhatamIdoing (talk) 01:26, 27 May 2024 (UTC)

You should try different words, like fake, quack, pseudo, etc. See this series about fake diagnoses. Ernst is the foremost expert on Altmed. -- Valjean (talk) (PING me) 03:41, 27 May 2024 (UTC)

I'm looking for something better in MEDRS terms than a blog post.

Also, the concern you express above for people who are seeking your help (which means they're seeking conventional medicine, right?) doesn't match with Ernst's "they tell you that something is wrong with you (despite the fact that you are entirely healthy)". WhatamIdoing (talk) 05:10, 27 May 2024 (UTC)

I got patients who had visited, or were also being treated, by altmed practitioners. They would be told the craziest things. They had delusions given them by these quacks. It sometimes made it hard to help them. They didn't trust doctors. I'm retired now. I've seen a lot. -- Valjean (talk) (PING me) 07:08, 27 May 2024 (UTC)

Bogus “alternative medicine” diagnoses described

Professor Edzard Ernst, who was the world’s first department chairperson in complementary medicine, has posted on his blog a four-part series on the fake diagnoses of so-called alternative medicine.

• Part 1 addresses adrenal fatigue, candidiasis hypersensitivity, and alleged chronic intoxications eliminated by so-called “detox” treatments.
• Part 2 addresses chronic Lyme disease, electromagnetic hypersensitivity, and homosexuality.
• Part 3 addresses leaky gut syndrome, multiple chemical sensitivity, and neurasthenia.
• Part 4 covers vaccine overload, vertebral subluxation, and yin/yang imbalance.

Valjean (talk) (PING me) 20:08, 27 May 2024 (UTC)

You seem to be operating from the stand-up comedian's definition of alternative medicine, rather that the scholar's definition.

But what we need is a source that says MCS, despite being covered in ordinary medical school textbooks, is alternative medicine. We don't need a source that says some treatments are bogus or that the etiology is pseudoscience. We just need a decent MEDRS source that puts "altmed" and "MCS" in the same sentence, without an intervening negative.

If you read Ernst's brief description, he says:

• He disagrees with the etiology that was claimed in the 1980s (so do I; from what I read, so do most mainstream researchers).
• He believes the patients have real symptoms (just not symptoms that are convenient for distinguishing MCS from, say, anxiety).
• Different researchers use different definitions (which is true for all sorts of conditions; see, e.g., Premenstrual syndrome, where the definition used in everyday office visits is 'has cyclical problems of any sort' and the definition used by researchers is 'has cyclical problems on specific days, one of which must be emotional in nature').
• He gives a list of "SCAM" treatments and declares that none of them have any evidence behind them.

What he doesn't say is: MCS is a diagnosis only used in alternative medicine. What we need is a source that WP:Directly supports the claim that MCS is alternative medicine/alternative diagnosis. WhatamIdoing (talk) 21:10, 27 May 2024 (UTC)

I'm going to resist the temptation to start pulling out my hair, and just repeat, AGAIN, that MCS is not "altmed". It's a bogus "diagnosis" that originated with, and is used primarily by, altmed therapists, but also by some doctors, many of them fringe. (Alternative medicine is not a thing reserved for non-professionals. Many fringe professionals and doctors are involved.) Please NEVER repeat that it's "altmed". That makes no sense, and I'm out of here if you do it again. Focus on the word DIAGNOSIS. Please. Sigh. SMH. WTF. Ughhhh.....

I cannot, alone, resolve your dilemma, as I don't recall how this category and wording were created. I may or may not have been involved. I am open to rewording/creating a different version that can fill the need for these unusual and bogus diagnoses. I started here in 2003 and registered an account in 2005. I can't remember everything. The decision to change it needs to be made somewhere else than here. Few people watchlist a page like this.

As far as discussing definitions of alternative medicine, I helped write much of that article. Just ask. I can approach this from various angles, from the comedian's to the scholar's. I have studied the subject since the 1990s, and have been familiar with death-by-altmed ever since my mother's horrible death from breast cancer at their hands many years ago. I was conscious of altmed as a child, but didn't really understand the issues, other than that a chiropractor friend-of-the-family was claiming to be a doctor, when he obviously wasn't. I understood that much as a ten-year-old. Much later, after getting two health care professional degrees, I could understand things much better. -- Valjean (talk) (PING me) 21:53, 27 May 2024 (UTC)

It's not altmed, but you want it in the altmed sidebar. Only altmed should be in the altmed sidebar, no? WhatamIdoing (talk) 23:27, 27 May 2024 (UTC)

In the "Alternative diagnoses" part. There are many sections in that sidebar, and a lot of fringey stuff is there. A lot of those diagnoses started in alternative medicine circles, not with mainstream medicine, and have gradually entered mainstream medicine, but not because they are accepted, just mentioned and discussed because patients tell their doctor about their "diagnosis". -- Valjean (talk) (PING me) 03:27, 28 May 2024 (UTC)

What's the difference between "entered mainstream medicine" and "they are accepted [by mainstream medicine]"? WhatamIdoing (talk) 22:18, 7 June 2024 (UTC)

Acupuncture

Having legitimate healing methods, like Acupuncture, called "fringe medicine" is inaccurate. It's used by millions of people all over the world, and has been used as a form of healthcare for 2500 years -- hardly fringe. It's also misleading to have it categorized alongside "fake Covid-19 treatments" -- it's not fake.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448339/ 141.155.7.168 (talk) 23:38, 19 July 2024 (UTC)

Moving herbal medicine under "Traditional medicine"

Regardless of its medical efficacy, herbal medicine is the predominant medical practice in many parts of the world, so it doesn't seem accurate to list it under "Fringe medicine". In Africa, according to the WHO, herbal medicine is utilized by 80% of the populace (varying from 60 to 95% by country).[3] The WHO estimates 30 to 50% of total medicinal consumption in China is herbal.[4] It would be more appropriate to list herbal medicine under the "Traditional medicine" section rather than the "Fringe medicine" section, as it is not "fringe" in most of the world, but simply traditional. Chinese herbology and ayurveda (which is mostly herbal) are already listed there. In fact, the majority of articles currently listed under "Traditional medicine" include prominent use of herbal medicine. Finally, our article traditional medicine is mostly about herbal medicine, so it's strange not to list it there. I understand the scope of the herbal medicine article is larger than traditional herbal medicine, but even the most modern industrial versions of herbal medicine are ostensibly based on traditional herbal medicine. Nosferattus (talk) 19:39, 15 October 2024 (UTC)

I wonder if we should also move acupressure, acupuncture, and cupping therapy under "Traditional medicine". Nosferattus (talk) 19:58, 15 October 2024 (UTC)

I think we are using "fringe" in the sense of its relationship to science-based medicine and scientific evidence, not based on the percentage of the populace which uses it. A majority of the populace can be ignorant enough to use hokey medicine because they have always done so. That doesn't make it mainstream, science-based, medicine.

I tend to agree that those could logically be placed under "Traditional medicine". -- Valjean (talk) (PING me) 22:00, 15 October 2024 (UTC)