Talk:Alternative medicine/Archive 20

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Revision Suggestion

I'd like to propose a revision to the "Testing of Efficacy" section, particularly here:

Cancer researcher Andrew J. Vickers has stated:

"Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good quality clinical trials, and they have been shown to be ineffective. In this article, clinical trial data on a number of alternative cancer cures including Livingston-Wheeler, Di Bella Multitherapy, antineoplastons, vitamin C, hydrazine sulfate, Laetrile, and psychotherapy are reviewed. The label "unproven" is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven.""[89]

This paragraph/quote represents an apparent conclusion of one commentator, Andrew J. Vickers, but isn't completely accurate or objective. For example, hydrazine sulfate has indeed been involved in a number of double-blind studies conducted in the United States and Russia. There are a number of studies published in peer-review that have shown a statistical advantage for patients receiving hydrazine sulfate who also suffered from non-small cell lung cancer and other tumor types. It is not accurate to say that hydrazine has been proven "ineffective" in all clinical trials. It is true to say that several studies also conducted at the behest of the National Cancer Institute either showed no effect from the drug, or were inconclusive. But not all studies were ineffective. One of the main issues here has to do with disagreements over whether trial patients were also receiving other MAO inhibitors which are alleged to negate the effects of hydrazine (also an MAO inhibitor) according to the drug's developer Joseph Gold MD. Gold argues this point, the NCI disagrees and the GAO seconds the NCI. But there are a number of controversies regarding the GAO findings. For example, an ammendment to their original NCI-suppportive report supports Gold's contention that mutliple psychotropic drugs were being used concomittantly with HS forcing even the GAO to write an ammendment saying that these findings only "add to the controversy".

Forgive me for trying to write a chapter on Hydrazine Sulfate! I'm only doing this to show how deep and complex the issues are and that the blanket statements, this drug is ineffective doesn't really even touch the tip of the iceberg.

Bottom line: hydrazine sulfate remains controversial with some patients reporting benefit.

Also, please consider the Vickers reference to Livingston-Wheeler. Only one clinical trial was conducted by Barrie Cassileth MD and published in the NEJM. In that study, neither group---Livingston's OR those treated conventionally---improved and both groups deteriorated at a similar rate. In addition, one-third of patients in the Livingston treatment arm were still reportedly receiving conventional therapy. Medical author Michael Lerner who is one of the most balanced commentators on alternative cancer therapies suggests that the results of the NEJM study could theoretically be interpreted to say that both treatments---Livingstons' and conventional--are "equally dubious".

I think it important to delineate that the Cassileth trial did not show a dinstinct and decided advantage of one treatment over the other in terms of treatment response and survival. In fact, Dr. Cassileth herself, explained at the study's conclusion that the Livingston results aren't necessarily applicable to results that might be gotten with patients less seriously ill treated in a similar trial---in effect, leaving the question open. At the very least, I think Cassileth's comments should be included here as she was the principal investigator of the study and one of the more prolific alternative medicine investigators in the nation.

One final point if I may. Gold never referred to hydrazine sulfate as a "cure". The Vickers reference to 'alternative cancer cures' thus represents a presumed conclusion on the authors' part but not a position advocated by the drugs' inventor. I have never heard any responsible party who has written about hydrazine sulfate refer to it as a 'cure' including Lerner, Moss or others. The drug is referred to as an adjunctive therapy that might improve patients' health statuses by neutralizing cachexia (weight loss) and possibly promote a control of disease over time though that question is still controversial. This reference might thus need some qualification or clarification.

I would be glad to offer any feedback regarding this revision as requested of me. Best Ronsword (talk) 16:30, 24 April 2010 (UTC)

Would it be OK to move this discussion to hydrazine sulfate? This page should have at most one or two sentences on hydrazine sulfate. II | (t - c) 23:05, 4 May 2010 (UTC)

Actually, a reasonable suggestion. Waiting to see how the discussion on hydrazine sulfate unfolds here - I believe with the intent of only including one or two sentences in this article.Ronsword (talk) 18:11, 15 May 2010 (UTC)

Proposed revision

Closing discussion per WP:NOT#FORUM WLU (t) (c) Wikipedia's rules:simple/complex 19:09, 17 May 2010 (UTC)

<span id="Closing discussion per WP:NOT#FORUM WLU (t) (c) Wikipedia's rules:simple/complex 19:09, 17 May 2010 (UTC)"> Here's a rough draft of the revision I'd like to propose as an addendum to "Testing of Efficacy":

Advocates of alternative therapies, however, present completely different viewpoints and cite what they say are deeply held, inherent biases against their treatments. For example, Dr. Joseph Gold MD, the developer of the cancer drug hydrazine sulfate, notes that while the FDA has officially stated that “Hydrazine sulfate has shown no anticancer activity in randomized clinical trials….” (U.S. Food and Drug Administration Transcript, meeting of Pharmacy Compounding Advisory Committee, Rockville, Maryland, May 7, 1999) there have been “many controlled human studies demonstrating the anticancer activity of hydrazine sulfate, dating from as far back as 1975 and published in leading peer-reviewed cancer journals which circulate worldwide” (references cited)

Gold also cites four nationally sponsored randomized double blind clinical trials establishing the drug’s anti-cancer effects (references cited). Other issues may involve biases inherent to studies used to assess alternative therapies. For example, the therapy of Virginia Livingston is officially considered “unproven” but the trial in question only included patients suffering from unresectable cancers not amenable to any know form of therapy. Author Michael Lerner questions whether such biases only insure a potentially negative outcome. In fact, both groups of patients (Livingston and those receiving conventional therapy) deteriorated at similar rates and none were cured, leading to a possible interpretation, as noted by Lerner, of both therapies being “equally dubious” regarding end stage disease (references cited).

Ronsword (talk) 16:01, 4 May 2010 (UTC)
Of course, this is excellent, and I believe it should be in the article. Ron, do not think that your earlier post has not been seen--many people watch this article and have read your post. As is pretty obvious from reading the alt med article, there is a very strong bias against it here at wikipedia. A few of us have tried to make changes to reflect the changing attitudes re alt med without any luck what so ever. For instance, a few months ago I assumed that it was appropriate to delete from the opening sentence in the lead, " that which has not been shown consistently to be effective."[2], which comes from a English prof at some state's folklore site! Eventually, after MUCH discussion, not only was it not deleted, it now appears twice in the article. Since then I just avoid this article. It will change eventually, but for now there is a core group of editors who will frustrate any changes that reflect the changing view of alt med. Gandydancer (talk) 16:28, 4 May 2010 (UTC)


Gandydancer Thank you for your comments. Wikipedia should most definitely not condone any selectively biased screening of material.

The fact is, Andrew Vickers' citation in "Testing of Efficacy" reflects the conclusions of a mainstream investigator who may be reflecting an institutional bias against alternative cancer therapies by virtue of his black and white conclusions. However, the issue is far too complex to be so black and white. For example, there are differing conclusions than Vickers' that have been rendered by other authorities regarding some alternative cancer theapies; how, then, can Vickers be the only source that supercedes all others as the citation of choice in an encyclopedia purporting toward objectivity? As I have written earlier, I am not a hydrazine sulfate advocate; I only present this addendum because there are numerous scientifically controlled, double blinded studies published in peer review journals worldwide which present a different perspective to what Vickers articulates.

I therefore wish to present this perspective to allow readers another concrete and scientific side of the equation. To not do so would be irresponsible in my view.

For those interested, here are a few of the citations I refer to:

1. Seits, J.F., Gershanovich, M.L., Filov, V.A., et al. Experimental and clinical data on the antitumor action of hydrazine sulfate. Vopr. Onkol. 21:45-52, 1975. 17. PMID 1090085

2.Gershanovich, M.L., Danova, L.A. , Kondratyev, V.B., et al. Clinical data on the antitumor activity of hydrazine sulfate. Cancer Treat. Rep. 60:933-935, 1976. 23. PMID 1009524

3.Gershanovich, M.L., Danova, L.A. , Ivin, B.A. and Filov, V.A. Results of clinical study of antitumor action of hydrazine sulfate. Nutr. Cancer 3:7-12, 1981. PMID 7050922

4.Filov, V.A., Ivin, V.A. and Gershanovich, M.L. (eds.). Medical Therapy of Tumors, U.S.S.R. Ministry of Health: Leningrad , l983, pp. 92-139. (in house publication)

5.Filov, V.A., Gershanovich, M.L., Danova, L.A. and Ivin, B.A. Experience of the treatment with Sehydrin (hydrazine sulfate) in the advanced cancer patient. Invest. New Drugs 13:89-97, 1995. PMID 749915

6.Chlebowski, R.T., Heber, D., Richardson , B. and Block, J.B. Influence of hydrazine sulfate on abnormal carbohydrate metabolism in patients with cancer cachexia. Cancer Res. 33:867-871, 1984. PMID 6692384

7.Chlebowski, R.T., Bulcavage, L., Grosvenor, M., et al. Hydrazine sulfate in cancer patients with weight loss: a placebo-controlled experience. Cancer 59:406-410, 1987. PMID 3791153

8.Tayek, J.A., Heber, D. and Chlebowski, R.T. Effect of hydrazine sulphate on whole-body protein breakdown measured by14 C-lysine metabolism in lung cancer patients: Lancet 2:241-244, 1987. PMID 2886716

9.Chlebowski, R.T., Bulcavage, L., Grosvenor, M., et al. Hydrazine sulfate influence on nutritional status and survival in non-small-cell lung cancer. J. Clin. Oncol. 8:9-15, 1990. PMID 1688616

Ronsword (talk) 17:00, 4 May 2010 (UTC)

Perhaps, Ron, you might take the trouble to link those citations with a DOI or a PMID as you go about looking them up? It would save us all time. We're interested to know if any might be reviews that meet WP:MEDRS. Cheers, LeadSongDog come howl 19:14, 4 May 2010 (UTC)
See hydrazine sulfate. I don't think this proposed revision will work. It's not clear what the inline citations are. For example, the statement "For example, the therapy of Virginia Livingston is officially considered “unproven” but the trial in question only included patients suffering from unresectable cancers not amenable to any know form of therapy" is unreferenced. This also might be too much detail for a page this high-level. II | (t - c) 23:05, 4 May 2010 (UTC)

Yes, the statement of Virginia Livingston being 'unproven' is in this citation: ^ Cassileth, B (April 25). "Survival and Quality of Life Among Patients Receiving Unproven as Compared With Conventional Cancer Therapy". New England Journal of Medicine 324: 1180.

The trial in question including patients with unresectable cancers is also per the NEJM article. Ronsword (talk) 23:32, 4 May 2010 (UTC)

LeadSongDog, I present a few examples of peer-reviewed citations below with their PMIDs suggesting validity for the use of hydrazine sulfate in the clinical realm; I hope you don't mind, but I simply pasted the entire abstracts for easier perusal.

. Vopr Onkol. 1994;40(7-12):332-6.

[Therapy of primary brain tumors with segidrin]

[Article in Russian]

Filov VA, Gershanovich ML, Ivin BA, Danova LA, Gurchin FA, Naryshkin AG, Leshchinskiĭ VI, Zemskaia AG, Nikiforov BM, Breĭvis PV.

The results of segidrin administration to 46 patients with malignant and 6 patients with benign tumors of the brain are presented. Pronounced therapeutic effect for the whole group was 63.5% and 73%, if partial regression of neurologic symptoms in the entire brain and separate foci is considered. These indexes for patients with malignant tumors only were 61 and 71.7%, respectively. Since segidrin has virtually no significant untoward side-effects, it is considered a most safe medicine for managing brain tumors. It is recommended in cases of inoperable tumor and for post-operative adjuvant chemotherapy with a view to extending the patient's survival time and improving the quality of life.

PMID 7610631 [PubMed - indexed for MEDLINE]

Experience of the treatment with Sehydrin (Hydrazine Sulfate, HS) in the advanced cancer patients. Filov VA, Gershanovich ML, Danova LA, Ivin BA.

Prof. N.N. Petrov Research Institute of Oncology, St. Petersburg, Russia.

Abstract The results of Sehydrin (Hydrazine Sulfate, HS) treatment of 740 patients with the advanced, recurrent or metastatic solid tumours of various localizations or malignant lymphomas, for whom all the methods of specific treatment (surgery, radiation, chemotherapy) had been exhausted are presented in this work. The objective response, symptomatic therapeutic effects and toxicity were estimated. Clinically significant objective responses were registered in patients with the soft tissue sarcomas, including neuroblastomas, and paradoxically--in such semimalignant tumours as desmoids. Although the objective response in patients with the lung cancer (90%--non-small cell) was only 4%, stabilization of long duration was registered in 22% of cases connected with the impressive relief of heavy common symptoms in 38.5% of the treated patients. Such a subjective response was established in 46.6% of all the 740 cases. The drug given per os was well tolerated by patients in primary and subsequent courses and did not induce myelosuppression or other significant side effects. On the basis of observations available, Sehydrin may be assessed as an alternative drug for the treatment and symptomatic therapy of patients with some advanced solid tumours and malignant lymphomas at a disease stage when the other methods of treatment can not be used. A possible mechanism of antitumour and symptomatic action is being discussed. PMID 7499115

Ronsword (talk) 23:53, 4 May 2010 (UTC)

Sorry Ron, I should have been more explicit. I wasn't suggesting we needed a copy of the abstracts, just a link to them. For now, if you simply were to add PMID 7610631 or PMID 7499115 (no colon) at the end of the citation, the mediawiki software would take care of generating the link. For this sort of purpose on some talkpages, people now skip the talkpage cites and just list the PMIDs. Both the examples you abstract above are primary studies, not the reviews that WP:MEDRS seeks. WP regards it as absolutely proper, even admirable, to discriminate on the basis of source quality. Pubmed makes it very easy to distinguish reviews. When viewing the abstract there, one just clicks on the "Publication type" and looks to see if it says "Review" or something lesser.
@II, thanks, but it looks as if only the Chlebowski et al. cites are on that article. I can look them up, but I'd prefer to try and help teach Ron the way to better wiki-collaboration. LeadSongDog come howl 06:11, 5 May 2010 (UTC)

Thank you and advice noted (see revised citations above). Also, II's point as to too much detail is a valid one. Presumably, said revision can be shortened to something such as

Advocates of alternative therapies, however, present completely different viewpoints. For example, Dr. Joseph Gold MD, the developer of the cancer drug hydrazine sulfate states that a number of clinically controlled "human studies demonstrat(e) the anticancer activity of hydrazine sulfate, dating from as far back as 1975 and published in leading peer-reviewed cancer journals which circulate worldwide” (references cited).
Michael Lerner notes potential issues with study biases in the evaluation of alternative cancer therapies. For example, the Livingston therapy was found ineffective in a government sponsored trial, but patients treated with conventional therapies were also found to deteriorate at a similar rate, and none survived (PMID 2011162). Lerner points out that all the patients in question were diagnosed with unresectable and incurable cancers raising questions about actual treatment efficacies and study design for both conventional and in this case, Livingston's unconventional therapy.

Ronsword (talk) 16:11, 5 May 2010 (UTC)

Comments? Ronsword (talk) 18:41, 10 May 2010 (UTC)

Thank you for linking those, Ron. It looks that each individually fails to rise to the standard for inclusion. WP:MEDRS calls for review papers, which none of these are. Searching pubmed for the three terms: "hydrazine sulfate" cancer review finds several hits, though most are older. Since 2002 there are three. PMID 16293879 and PMID 15061600 were both clearly against the use of hydrazine sulfate, while the latest, PMID 16768027, (full text here)is in Spanish. While my Spanish is anything but strong, I'm pretty sure that the conclusion "El Sulfato de Hidracina no debería utilizarse por su inefectividad como estimulante del apetito" is in line with the other two. LeadSongDog come howl 19:51, 10 May 2010 (UTC)
Agreed, HS is one of those treatments considered "disproven" rather than "unproven", per [1]. We must consider first what the best sources say, and unfortunately those are usually in English. WLU (t) (c) Wikipedia's rules:simple/complex 01:08, 13 May 2010 (UTC)


I won't quarrell the above points, and I will yield to the majority. Though I would like to clarify for the record, hydrazine sulfate (HS) has only been "disproven" depending on the sources cited. In Russia, for example, the drug (named "Sehydrin") has been "proven" in multiple peer reviewed, clinical trials, and is prescribed routinely for cancer patients as an adjunctive not front line therapy. Russian scientists have found that HS---which has never been considered a cytotoxic drug---results in "disease stabilization" i.e., halting of tumor progression (not necessarily reduction of tumor mass---an endpoint not claimed by its developer) in 30-35% of patients so evaluated. The Russians have had extensive clinical experience with HS spanning three decades and involving over 700 patients For those interested, please see full article at: [2]. Finally, the Russians are aware of, and have addressed the 3 negative clinical trials sponsored by the National Cancer Institute, offering their views on why their American colleagues' results differ from their own. I personally remain somewhat agnostic on the entire issue (it is an extremely complex one), but hardly feel empowered enough to argue that one group of American investigators are right, and the rest of the world is wrong Ronsword (talk) 16:46, 14 May 2010 (UTC)

The article by Filov et al. that you link to is PMID 7499115. Just to clarify, it has nothing to do with nationality and everything to do with the science. Unless I misread it, even Filov found HS to be nearly irrelevant to disease progression, though perhaps helpful for appetite in palliative use. The later papers discussed above found the appetite evidence to be inconclusive at best. LeadSongDog come howl! 18:47, 14 May 2010 (UTC)

LeadSongDog, you're correct, nationality should have nothing to do with it as per the comment posted above that the "best sources" are "unfortunately usually in English".

FYI I'd suggest reading the full text article I provided above (see URL) for better perspective. It is incorrect to say that Filov found HS to be "nearly irrelevant to disease progression". In the study I cite, he clearly describes disease "stabilization" as synonymous with "interruption of the tumour progression". In that regard, 'interruption of the tumour progression' of more than "3 months... was observed in 216 out of 740 patients (29.2%). Filov continues that "Stabilization (totally in 35.5% of patients) was most frequently observed in the patients with the Hodgkin’s disease, breast, lung, rectal, and colon cancer, in hypernephroma (in 5 out of 9 patients), generalized melanoma (in 13 out of 31 patients), soft tissues sarcoma (in 19 out of 39 patients), head and neck cancer (23 of 48 patients) and in the disseminated b cancer (28 out of 66 patients). It must be re-emphasized that the objective responses and stabilization of the tumour growth occurred in patients having the terminal phase of the disease".

[Also per the Filov study, 6 advanced and unresectable cancer patients experienced complete and total remission. While too small a number to ascribe any significance, it is nonetheless interesting considering the usual odds for spontaneous remission are in the estimated 1:60,000/1:100,000 range].

Incidentally, this trial was published in 1995---several years after the negative NCI sponsored trials commenced. And the latter trials are addressed in the Filov article. If I'm reading the data correctly, the last large scale trials conducted in the US were concluded in 1994. Several of the newer citations you mention are, I believe, references to the earlier negative trials but not additional and contemporary trials. Thus, rehashing earlier negative trial results doesn't necessarily comprise a new body of research.

To reiterate, Sehydrin continues to be prescribed as a proven cancer adjuvant drug in Russia based on the above quoted citations. Thus, Hydrazine sulfate is now "disproven" in the United States, but "proven" in Russia. That is simply a statement of medical and historic factRonsword (talk) 19:58, 14 May 2010 (UTC)

What's the best, secondary source for HS being used in Russia? If it's good, I'd be in favour of a "Though used as an adjuvant in Russia, in the United States HS is considered a disproven approach." What's the source for the Russian statements about the American trials? WLU (t) (c) Wikipedia's rules:simple/complex 16:33, 15 May 2010 (UTC)

WLU, the source you are asking about is in the Filov published article of 1995 [3]]. I include a link to the full article text here because the abstract PMID 7499115 doesn't include the discussion/observations of the Russian oncologists concerning the failed NCI studies. In that discussion, Filov et al. specifically reference the 3 most current NCI sponsored trials that failed to show any benefit from HS (PMID 8201372, PMID 8201374 and PMID 8201373) as per their own article references 17,18, and 19. Filov acknowledges that his own trial also didn't show "tumor regression" but instead, cessation of tumor growth - that being a major point of disagreement among the Russians. They consider HS an adjuvant used for disease stabilization as opposed to its objectively cytotoxic role.

For your benefit, I include the Filov conclusions below. (Note, when he references "single-arm trial" as per first sentence, he is talking about his own Russian trial. Please also note, when Filov references "frequency of stabilization" he is describing interruption of tumor progression):

The most important question is the one: whether the data from the single-arm trial being presented are contradictory to the ones from the randomized placebo-controlled, double-blind, multicenter clinical studies mentioned above that failed to demonstrate any benefit for HS in the advanced colorectal cancer [19] or non-small cell lung cancer when this drug is administered along with the combination chemotherapy - cisplatin and etoposide 18 or cisplatin and vinblastine [ 17]. The comparison of the data from Table 1 and from the first of the mentioned publications makes it understandable that there are no significant contradictions in them. No tumour regression was seen in the multicenter trial (NCI) in both the placebo and HS groups, while in this phase II trial PR (partial remission) were registered only in 5% of the patients that was within the limits of the measurement error. The frequency of stabilization (i.e. interruption of tumor progression) is not indicated in the article, and the evaluation of the other therapeutic effects of HS was made with the use of different parameters: in the randomized (NCI) study - quality of life according to the performance status, appetite, weight ratios, survival rates, and in this study - according to the effect of the drug on the separate disease symptoms. That is why the data are not comparable and can not be used as an argument against the results of this single-arm trial.
In the other two above-mentioned trials [17, 18] HS was given simultaneously with the chemotherapy drugs. Meanwhile, HS is not "a neutral substance” as regarding to the effects of cytostatics. Experimental data have indicated that the combination of HS with some of the cytostatics may result in the additive therapeutic or antagonistic effect [20].
The question of what type of these effects manifests itself in case of the combination of HS with cisplatinum, etoposide and vinblastine remains... unclear. Anyway, until the special experiments on this subject are....carried out, it is possible to suppose that HS has a relatively probable unfavourable “intervention” into some of the variants of chemotherapy, and hence, that it is impossible to evaluate these data from the phase III trial as an argument against the results of the single-arm trials.Ronsword (talk) 17:37, 15 May 2010 (UTC)
  • I don't think this is likely going to fit into here, as this is a fairly high-level article, but some more detailed discussion on the substance could go into hydrazine sulfate and possibly even alternative cancer treatments. Filov's article is cited and discussed in [[ The HS article doesn't present the timeline in the same way that you do in Hydrazine_sulfate#Clinical_trials, which could perhaps be improved. Can we move that part of the discussion? Is there anything for this article that you think needs to change Ron? II | (t - c) 08:12, 16 May 2010 (UTC)
Agreed, this discussion would probably be a better fit for Hydrazine Sulfate and I have no problem with moving it. But let me clarify, II, I think the reason for the back and forth here (extensive as it has been) has been to address the issue of modifying a few brief sentences in the "Testing of Efficacy" section, this article. Thus, WLU proposed the following revision: "Though used as an adjuvant in Russia, in the United States HS is considered a disproven approach." So I guess the proposed revision/addition here consists basically of one or two sentences. Thoughts?Ronsword (talk) 15:16, 16 May 2010 (UTC)
Ugh, that's 15 years old, no research has been done since then that I can tell, it's only been cited 11 times (and not by a lot of mainstream research), it's still not a mainstream treatment, and even in that refrence there's no information about increased survival time. Based on that, I don't think it's good to portray it as positive or useful as a form of cancer treatment. If that's the best information available about HS, I don't think there's much reason to include it in the page. WLU (t) (c) Wikipedia's rules:simple/complex 11:36, 17 May 2010 (UTC)

You suggested the modification: "Though used as an adjuvant in Russia, in the United States HS is considered a disproven approach." The current Russian use of Sehydrin is indeed a statement of fact. Thus, can you tell me in earnest why readers of an online encyclopedia should not know this fact?Ronsword (talk) 15:00, 17 May 2010 (UTC)

In Mexico they use HS, the Gonzalez regimen, laetril, coffee enemas, high-dose vitamin C, etc. That doesn't mean we note it. We should base this on the best evidence - and that evidence isn't great. In fact, I was going to suggest mentioning it's possible use as an antianorexic, until I saw this. Also, if you note, my initial comment was qualified with a question about the best evidence, and only if the evidence was good, would I support such an inclusion. Well, that's not a good source. It's old, and contradicted by other, newer sources. That seals it for me. WLU (t) (c) Wikipedia's rules:simple/complex 15:05, 17 May 2010 (UTC)
Also, reading through the source itself, it seems rather badly written (could be a bad copy-paste from a PDF though) but more substantially than that - it is a primary source, per WP:MEDRS. It's the reporting of the results of a single trial, which we are urged not to use, particularly not for a high-level article like this one, and certainly not to vindicate an entire approach like alt med. From a scientific perspective, it appears to lack randomization, matched controls, placebo groups, the history of the patients is hopelessly heterogeneous, the end measure was progression or not, rather than say, five-year survivability (clinical indicators are useful, but far less meaningful than death rates), the use of self-reported symptoms is also problematic, and the results themselves are hardly a slam-dunk. They claim a therapeutic effect only after several cycles, when it could be a matter of several cycles merely indicates the person wasn't going to die in the first place. It uses anecdotes to "demonstrate the effects" of HS. I'm not surprised this study isn't heavily cited, and I'm not surprised it had virtually no effect on HS being considered a "disproven" remedy. The lack of controls is crippling and means you can never tell if the effect is due to HS or something else, or for that matter whether HS actually increased mortality. This study was essentially a waste of money. As the study says, the data are not comparable with other investigations of HS, but not for the reasons they give. This primary source study is not appropriate to adjust any page; I wouldn't even mention it on the hydrazine sulfate. This study tells the adequately informed reader nothing. Yuck. It is typical of the poor-quality research that tends to infect alt med studies though, both in terms of a lack of controls and shoddy reporting. "Feeling better" after being given something is not an outcome, particularly if it is not compared to a placebo control. WLU (t) (c) Wikipedia's rules:simple/complex 15:30, 17 May 2010 (UTC)
Disease stabilization is a meaningless endpoint unless you have a control group. Cancer progression is notoriously unpredictable, even in a "terminal" setting. So if you follow a single uncontrolled cohort, some percentage will have "disease stabilization" (or lack of progression) at a given time point, even if they receive treatment at all. In order to distinguish a drug effect from the natural history of the disease, a control group is necessary.

The difference between the Russian and Western studies is simple: the Western studies were placebo-controlled and randomized. The Russian study was an observational cohort. It's that simple. That's why the Russians reported a positive finding and the Western studies didn't. A scientifically literate individual would assign more weight to the randomized, placebo-controlled results than to the uncontrolled observational cohort. MastCell Talk 16:16, 17 May 2010 (UTC)

The Chlebowski studies were double blinds and found "statistically favorable" responses from hydrazine sulfate.
Incidentally, for the record, I forgot to mention that hydrazine sulfate is also an approved and legal drug in Canada--a 'scientifically literate' country. But be assured, I don't believe the Canadian pharmaceutical society also endorses the use of coffee enemas!(LOL). The drug is also---for better or worse---used legally and illegally worldwide.
As I've said earlier, I won't continue quarreling the point if it's not quite right for Wikipedia. For the record, and for those who wish to understand the nuances of this complex controversy which in my opinion, is not resolved, please see here: [4] Ronsword (talk) 16:43, 17 May 2010 (UTC)
It is odd that none of the authors of Filova et al. 1995 have since published anything more on hydrazine sulfate in the past 15 years, though they have certainly published on other topics in medical oncology during that time. Is there a more recent reliable source to back the assertion that its use, even in Russia, is continuing? As for the assertion about Canada, again, citations are needed. LeadSongDog come howl! 16:50, 17 May 2010 (UTC)
Again, wikipedia is based on secondary sources, not primary. Also, what is HS approved for in Canada? I looked on Health Canada and frankly couldn't even find where to look. Being used world-wide isn't the same as being effective worldwide. And none of this addresses the fact that this is the alternative medicine talk page, not the hydrazine sulfate page. So frankly, if anyone wants to keep talking about hydrazine sulfate, they should go to talk:hydrazine sulfate. WLU (t) (c) Wikipedia's rules:simple/complex 17:24, 17 May 2010 (UTC)
Interestingly, the Canadian Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative did a review of HS in 1998 (PMID 9614826) and concluded that the concurrent use of MAO inhibitors with HS (also considered an MAO inhibitor) in the NCI negative trials render the "potential benefits of HS as an adjunctive therapy in the management of cancer...controversial". Kaegi et al also said: "there is good evidence that HS inhibits gluconeogenesis...and may play a role in reducing the severity of cachexia and improving the quality of life of cancer patients".
Of more interest, however, were the authors' response to the claim that the final verdict on HS should be rendered as "ineffective". The Canadian authors argue, instead, that the current verdict should be "uncertain" (and certainly not "disproven"). See Kaegi's response to this claim and the controversy surrounding the GAO investigation of the NCI trials here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1230613/pdf/cmaj_161_6_686.pdf
In summation, the hydrazine sulfate issue is far from resolved. The 3 American negative trials which included known incompatible agents---admitted by the General Accounting Office---are not the end of the story. Whether or not the single sentence "hydrazine is a drug that has been approved in other countries" is worth mentioning as a historical fact in an article on Alternative Medicine or elsewhere is thus left to Wiki editors knowledgeable of the nuances of Wikipedia protocols and the like.Ronsword (talk) 17:24, 17 May 2010 (UTC)
Please be more careful in your representation of the published literature. You've juxtaposed a quote from the Canadian article inappropriately - their description of "controversy" was not linked to the use of MAO inhibitors, but was a general statement. Patients in the NCI trials were not given MAO inhibitors anyway - they just weren't explicitly barred from receiving them. Furthermore, the GAO found that the NCI's protocols were "appropriate given the information available to them" - which is a supportive statement, not an "admission" that the trials were invalid. That's three misrepresentations right there, ranging from minor to extremely questionable. MastCell Talk 17:44, 17 May 2010 (UTC)
I promise WLU, not another peep on HS here. Only reason I am posting is because contributors keep raising points and questions.68.204.111.27 (talk) 17:42, 17 May 2010 (UTC)
Ya, the conclusion of that 12 year old paper is that it may have a role in quality of life, but it's status as a chemotherapeutic agent is unclear - in other words, there's no evidence that demonstrates antitumour properties. And as I pointed out above, lots of sources demonstrate that it's considered disproven. All the shoddy-quality trials in the world are of no use in determining how useful HS is, and the best trials demonstrate no effect. That is what we demonstrate on all pages - though this applies to HS, it's a lesson that should be taken to heart for all of wikipedia. We report the mainstream, we are not a soapbox to proclaim a treatment unjustly maligned. The other contributors to this page are politely saying to you that HS is essentially worthless as a cancer treatement agent, and cherry-picking studies doesn't help (though it does foster false hope in cancer patients who then waste what remaining time and money they have on interventions like this one; it also forces researchers and research funding agencies who are looking for real treatments to waste time and money investigating improbable or disproven treatments when advocates keep claiming it wasn't quite right - such as vitamin C megadoses which is now being re-investigated because it wasn't intravenous). After a certain point, real researchers give up pet theories and move on to more promising investigations. Quacks don't, they just claim conspiracy from Big Pharma. And keep shoddy records of everyone who doesn't get better, so they can claim a 90% success rate. WLU (t) (c) Wikipedia's rules:simple/complex 17:53, 17 May 2010 (UTC)

Ya, the problem with the 'best' trials you refer to is that they were, in fact, considered flawed by other reputable scientists. These trials included the potentially fatal use of incompatible drugs---MAO inhibitors---with hydrazine sulfate, also an MAO inhibitor. Is it quality science, or shoddy science to include two or more incompatible agents in a carefully controlled study trial? Therefore, I referenced the Kaegi article because its conclusion of "uncertain" is based on this very controversy (e.g GAO's admission that the NCI trials did in fact allow additional drugs that were not supposed to be allowed). Yes, the Kaegi article is 12 years old---and written 5 years AFTER the NCI trials which are now, um, 16 years old.Ronsword (talk) 18:25, 17 May 2010 (UTC)

Again, please be a bit more scrupulous in paraphrasing. The Canadian review makes clear that it is only Gold and a few other "supporters" of hydrazine sulfate who claim that MAO inhibitors are contraindicated or "potentially fatal". As the Canadian paper notes, scientific support for such an interaction is "limited" at best, but Gold "insists" that it is real. It is a stretch of the imagination to blame this scientifically unsupported interaction in an unquantified number of study patients for the negative outcome. Of course, the question is easily resolved - if one believes that MAOIs are to blame, then it would seem incumbent upon them to conduct an additional randomized, controlled trial in which MAOIs are strictly prohibited. Have Gold or other HS proponents conducted such a study? MastCell Talk 18:45, 17 May 2010 (UTC)
Agreed. Then why doesn't NCI launch additional randomized, controlled trials restricting MAO's? [Are only Gold and a 'few supporters' correct or incorrect in asserting that combined use of MAO's can have potentially fatal outcomes?] Ronsword (talk) 19:02, 17 May 2010 (UTC)

I don't believe I have taken the Canadian article out of context. The Canadian citations I quote are, in fact, related to the GAO controversy. If you read the PDF link I provided above, the Canadians---in addressing criticisms of their conclusion of "uncertain" in a later editorial (1999) write that their "concerns" ..."were reinforced by our review of additional material pertaining to an investigation into the conduct of the HS trials, which was...carried out by the GAO." One can reasonably infer from this last sentence that they are referring to the GAO's concerns about MAO's---the primary thrust of the GAO investigation in the first place.

The Canadian's thus conclude that "on the basis of that material, it was entirely reasonable to conclude that the evidence for and against the efficacy of HS was uncertain".

I can't speak to Gold's objections to MAO incompatibility. But from a purely pragmatic standpoint, I again ask the question: is the use of two or more incompatible drugs in a clinical trial good or bad science---non withstanding efficacy outcomes?Ronsword (talk) 19:02, 17 May 2010 (UTC)

Gentlemen, this is all very fascinating but the purpose of the talk page is to discuss improvements to the main page. Based on the discussion, this isn't going to happen. So if people want to debate this further, I have one word - email. WLU (t) (c) Wikipedia's rules:simple/complex 19:09, 17 May 2010 (UTC)

Characterization

The "characterization" section looks very good, at least in principle. One problem: under the section headed by "Scientific community", "institutions" are given far less space than "scientists", even though it is widely accepted on WP that institutions are superior sources for scientific topics (see, e.g., WP:MEDRS). By word count, "institutions" receives 100 words and "scientists" receives 546. More specifically, Stephen Barrett (most of whose work is self-published without indications of peer review) alone gets 110 words, more than the entire "Institutions" section; the Institute of Medicine, one of the best English-language sources for the life sciences, gets only 26 words. One might justify that state of affairs by arguing that Barrett and others have published a great deal more than some of the scientific bodies cited: the NSF, for example, devotes only 7-8 paragraphs to CAM in a paper discussing science fiction and pseudoscience. The IOM, however, published a 360-page book, Complementary and Alternative Medicine in the United States. (Barrett has criticized the IOM book, but his criticisms depend on CAM being held to a different set of ethical standards of research than biomedicine, and if anything, his reasoning, tone and self-publication show how far he has diverged from mainstream discourse.)

Yes, sometimes we do need to rely on less than wonderful sources (like Barrett) as "balancing" sources when few sources other than promoters of a given CAM exist. But for characterization of CAM itself, we have an extremely high-quality source in the IOM, one that is superior to any individual scientist publishing via peer review, let alone scientists who self-publish and eschew the peer review process. Yet this source is given extremely short shrift. Therefore, we have a major undue weight problem as things currently stand. Does anyone disagree? regards, Middle 8 (talk) 01:27, 3 June 2010 (UTC)

Would you like to propose some wording from the IOM? That might be a good place to start. -- Brangifer (talk) 02:26, 3 June 2010 (UTC)
Sure; in a nutshell, I'd expand the "Institutions" section and prune the "Scientists" so they were, at a minimum, 50:50. I'm pretty busy IRL so am not in a rush. Just wanted to get a sense here of how other editors feel about the general idea before proceeding. regards, Middle 8 (talk) 04:59, 3 June 2010 (UTC)
Expansion...yes. Pruning....no. This edit drastically reduced the size of the article and changed its format. I can hardly recognize it anymore. -- Brangifer (talk) 06:02, 3 June 2010 (UTC)
@Brangifer: Wow, that's some diff. I take it you don't necessarily consider it an improvement, but there was adequate consensus for it? Don't worry, I won't delete anything. In this case, adding sounds better. --Middle 8 (talk) 03:49, 7 June 2010 (UTC)
Exactly. If I haven't been involved in a discussion of such a change, I usually don't revert, as long as there has been adequate discussion. I feel the old format was good and conveyed the sense of reality.....that there is much discussion and not full agreement. I hope that didn't get lost in that huge edit. It was so huge that I can't figure it out and I don't like headaches! -- Brangifer (talk) 14:13, 7 June 2010 (UTC)
I agree with BR. Expand don't delete. Verbal chat 06:22, 3 June 2010 (UTC)

Efficacy of complementary medicine in children

The evidence-base for complementary medicine in children: a critical overview of systematic reviews. Reference for article. QuackGuru (talk) 03:33, 6 September 2010 (UTC)

Levity

If editors here need a break, I'd suggest today's episode of [The Irrelevant Show], which has a nice bit on "alternative crime". Enjoy. LeadSongDog come howl! 21:15, 27 November 2010 (UTC)

complementary?

uf, I see talk pages here are huge, could there be a FAQ page, made by editors which have been involved in this article for a longer time? I see the issue was debated many times, but getting to the gist of the argument seems fairly time consuming if it means digging through archived conversations. I'm simply wondering if either the article or title or both might reflect the opinion of some who consider complementary and alternative medicine quite distinct - for instance, Prof. Michael Baum Interview from "The Enemies of Reason." , or at least the uncut version of it available at Richard Dawkins Foundation channel - where he takes 'alternative' to mean basically unproven alleged remedies, and complementary only to actually proven medicine that 'complements' traditional treatments - he worked with art therapies, and proven herbal remedies, though its not clear to me what he actually means by 'complementing'.. Aryah (talk) 20:19, 27 June 2010 (UTC)

Integrative Medicine is NOT the same as "Alternative" medicine. I really think it should have its own page and not be redirected. Integrative Medicine is the use of western/ allopathic medicine in combination with other non-conventional yet *evidenced based* treatment modalities. It differs from the old termenology "CAM - Complementary and Alternative Medicine" because of the strictly controlled research component -- in other words, only using treatments that have been researched and shown to be as effective as other treatments (i.e. the use of acupuncture for chemotherapy induced nausea and vomiting. See reference at http://www.annualreviews.org/doi/abs/10.1146/annurev.med.51.1.49?journalCode=med) This is why Harvard, Yale, Columbia, Hopkins, UCLA, UCSF and all other big name MED schools have an Integrative Medicine dept., NOT a "Complementary and Alternative Medicine" department. —Preceding unsigned comment added by Berkeley19 (talk • contribs) 05:48, 3 December 2010 (UTC)

Appeal

This section may warrant a bit of cleanup, especially the second through fourth paragraphs. For one thing, there are six citations of an article from The Scientific Review of Alternative Medicine, which appears to serve as the Center for Inquiry's anti-CAM editorial page. Compounding the potentially POV tone, the statements taken from these 'speculations' begin to be worded like facts. For instance:

"There is also an increase in conspiracy theories towards conventional medicine and pharmaceutical companies..."

On that subject, I believe the term 'conspiracy theories' might be a bit weighted. Perhaps some expansion with references cited on these pages would be helpful.

http://en.wikipedia.org/wiki/Pharmaceutical_industry#Controversy_about_drug_development_and_testing http://en.wikipedia.org/wiki/Pharmaceutical_industry#Controversy_about_drug_marketing_and_lobbying http://en.wikipedia.org/wiki/Criticism_of_the_Food_and_Drug_Administration

Apologies if this has been discussed. Any thoughts? AveVeritas (talk) 14:29, 1 January 2011 (UTC)

Removed "Rationalization" section as it was entirely uncited; science-based medicine

At this point on Wikipedia, we don't really accept new edits without sources, especially in controversial areas where there could be a lot of disagreement. So I removed the new section, which was recently added by User:PPdd. The section had an obviously rather negative spin on alternative medicine, which is OK but it needs to be sourced and also probably balanced by a rebuttal per WP:NPOV. Ideally, we have an academic source which doesn't seem to be on a crusade but is rather documenting facts.

I noticed that the section used the phrase "science based medicine", as contrasted with alternative medicine. This type of comparison needs to be sourced. I would prefer that we try to avoid this term, which is rarely used in sources, and rather stick with the more standard term of mainstream medicine or conventional medicine, or perhaps if appropriate evidence-based medicine. Science-based medicine is associated with a small group of bloggers over at the website Science-based medicine. While they have a lot of good articles, they also have quite a few bad ones and tend to lean very traditional and pro-industry (ie, use a lot of drugs, don't worry much about side-effects, drug companies don't really distort research, xenobiotic chemical exposures are nothing to be concerned about, etc) - for example, when their founder Steve Novella decided to look into Bisphenol A, he just invited a chemist from the industry trade group to give a podcast lecture without any counter view, which is somewhat representative of the group's approach to questions. It's not a reliable source and we shouldn't be discreetly plugging them. II | (t - c) 19:30, 21 February 2011 (UTC)

No problem, I should have RSd it before putting it in. Re pro-industry POV, I was invited to lecture at MIT on neuroethics by, of all departments, one of the chemical engineering department's biochem industry fundees. After they had already flown me out, they found out about my self-funded studies on psychopharaceutical abuse and indirect refunding of the industry by MIT funding pill pushing psyciatrists, and I was summarily disinvited. But Science Based Medicine's has information sourcing in addition to their blogging, and it is very reliable. I have yet to find an error that was not immediately retracted, and very few erros in the first place, as the information in its non-blog information section is peer reviewed by a team of expert editors. PPdd (talk) 21:04, 21 February 2011 (UTC)

Alt Med journals revisited - Application of MEDRS re biomed conclusions "peer reviewed" by alt med and pseudoscience journals

Alt Med journals revisited: Application of MEDRS re biomed conclusions "peer reviewed" by alt med and pseudoscience journals - Application of MEDRS re biomed conclusions "peer reviewed" by out of field non-experts is being discussed here[5]. PPdd (talk) 16:05, 22 February 2011 (UTC)

The placebo effect

I have been trying to fix this article to reflect the fact that the placebo effect has been considered, studied, puzzled, and so on in the medical community for some time. It is well known that even voodoo "works". What is not so well known is that antidepressants, for instance, except in severe depression, don't. Except that they do work, due to the placebo effect. (Though unfortunately some pretty serious side effects "work" extremely well, too.)

It seems we have a new editor who is hell bent on letting wikipedia readers know that they are being lied to by alt med about the placebo effect. The problem that I'm running into is the fact that he is using an article in the NEJM, written by physicians, supporting the use of the placebo effect, not some wild and crazy alt med proponents. If I do not understand the situation, please let me know. But if I am correct and he does not make that plain in the article, I am going to delete his edits. Gandydancer (talk) 01:55, 23 February 2011 (UTC)

I don't know about your characterization of my motives. I consider my mind being referred to as "bent and twisted" a compliment, so I guess "hell bent" os even more "complimentary". :)
Back to seriousness, this issue of IM MDs arguing that alt med is useful because it achieves a placebo effect is very common in the field. It is the most common argument I have heard in 11 year of direct personal integrative medicine (forced) exposure. It is what you hear when an integrative med doc is at a lunch table in a med school cafe, sitting with non IM docs, trying to justify alt med. It being such a very common justification for alt med by proponents, I thought it merited a sentence in the article. But finding a written source for it has been difficult. I provided the quote in the ref for clarity, so I am not sure I understand your misunderstanding. Did you check the ref where I directly quotes one of the chief academic institution IM proponents of alt med? PPdd (talk) 02:57, 23 February 2011 (UTC)
The placebo effect is quite powerful and one finds in controlled-antidepressant trials that placebo and drug depression-relief scores go up at the same rate for the first 3 weeks or so. And this is a good rate. Since it's the same for both, it's entirely due to the patient's expectancy that they're now taking something that will help, and the depression won't last forever. The divergence between placebo and drug that happens after that, is drug effect, not placebo effect. All physicians know about the placebo effect and all know that it comes "for free," even with active drugs (an actual placebo pill isn't needed). The main question is then how much confidence should be placed on this effect, to the extent of perhaps considering use of an active drug that may not be as effective (by itself), but also has fewer side effects (is not as dangerous). I believe that amoxicillin is used this way in pediatrics, and that's one of the things that makes it one of the most prescribed drugs in America.

By the way, I almost wrote that perhaps the doctor should consider using a cheaper drug while waiting for the placebo effect, but in part that undermines the effect itself. It's well-known that a $50 antibiotic prescription works far better than one that is only $15. I actually believe that this is part of "amoxicillin-resistance"! SBHarris 02:48, 23 February 2011 (UTC)

My problem with Gandydancer's added source about anti-depressants is that it has nothing to do with alternative medicine, so on that basis alone, besides all the other things I mentioned in my edit summary, it's not allowed here. I'll let someone else remove it as its use violates policy. We must stay on-topic, also with our sources.
As to the so-called "power" of the placebo effect, it's not as powerful as previously supposed. Danish researchers studied all the literature, found that most of it was based on the fallacious first big claims, and that its main effects are primarily subjective, with no significant or lasting effect on serious illness, something which many believe, especially in altmedland. Read the article, especially about its clinical significance, which isn't nearly as much as claimed. -- Brangifer (talk) 07:02, 23 February 2011 (UTC)
Well, what can one say about an article that thinks that "clinical" means "objectively measurable?" So what if placebos really are only good for pain and subjectively-reported outcomes. That's about half of the practice of medicine-- maybe more. Spare me from the guy who says that the patient is not actually doing better with his pain, depression, and anxiety-- he just THINKS he is doing better. And tell me: what's the difference between the two patients who have exactly the same set of objective pathologies, yet one is reduced to a quivering blob of worry and pain, and other is handling it like your dog or cat would-- with the minimal amount of dysfunction that the physiology itself requires by nature of the laws of physics. But not much more than that. SBHarris 08:29, 23 February 2011 (UTC)
PPdd, thanks for the little bit of fun - it is good to lighten things up a tad. But back to seriousness, you say, "But finding a written source for it has been difficult. I provided the quote in the ref for clarity, so I am not sure I understand your misunderstanding". In the first place, I have never seen an editor include a quote in the ref (for clarity), and in the second place, your ref is a blog. Actually, I am surprised that LeadSongDog and Brangifer (correctly) had a problem with the ref I used, but seem to have no problem with your blog.
But the problem I was getting at when I started this discussion is the fact that it seems you are attempting to show that alt med and IM are guilty of pushing placebo as a cure while actually using an article written by an MD and appearing in the NEJM to reference that "fact". You said yourself that you repeatedly attempted to get the NEJM to retract the article without any success what so ever and you remain irritated that the NEJM has, in your opinion, gone over to the dark side, so as to speak. But the fact remains that the author of the study is an MD, he has written hundreds of peer reviewed articles, and he even teaches med in Maryland. The article did not appear in some alt med journal by a person of dubious background. How can you use a NEJM article about the placebo effect to reference your claim that alt med "lies" to patients by using the placebo effect when that does not at all represent the article's content? Gandydancer (talk) 13:07, 23 February 2011 (UTC)
I always provide a quote when the ref is not accessable without paying, or when it is only a hard copy ref, and especially if it in a foreign language and translated by me.
The ref was not intended to be a blog. I will include the actual NEJM article as a ref. I put the "blog" in as a ref because it quoted the NEJM article, which is the actual source, but is not accesabile to Wiki readers unless they pay, so since the blog has the quotes, I thought it would be helpful. Science Based Medicine is both a reliable secondary reference source for its articles, and it contains blogs. But the "blogs" are more like "blog plus", since they are opinion plus editorially reviewed fact, so are not purely blog.
"Lies" is POV, and I should not have used it. My only defense is what I call "the Anderson Cooper defense". Anderson Cooper reported in a news story that Mubarek was lying, which is not journalism, unless there are two sources to confirm that Mubarek deliberately said something that he knew was false to deceive someone. Cooper had just been beaten up by Mubarek thugs, so his slip was understandable. My background includes 11 years of data analaysis at stanford, and a respect for NEJM. I got personally frustrated when there was an admission that maybe the IM author, a preeminent IM spokesperson, and as you point out, a professor of medicine, should not have concluded that a review indicates acupunture is a placebo and that it should serve as a complementary treatment. But who cares if an IM doctor would state such a conclusion; it is expected. But there was no admission that NEJM should never have published this conclusion, and I wrote the edit with a frustration about this. I think I will go over and make an edit in the NEJM article about this. So that's my "Anderson Cooper defense".
In the meantime, I should correct the POV wording in my edit here, and provide the NEJM article as a ref, not just the blog. (I thought I already did that, but even if I did, I should make an invisble comment in the blog ref as to why it is being used, even though it is a blog, as having free content quotes from the pay to view article.)
Finally, as to "lie to the patient" (which might have a less POV wording, but rewording "duck" to be "looks like a duck and quacks like a duck" is also POV), the MD in question is a national spokesperson for IM, so his published words are RS for what alt med pushers practice, and he often times publically makes the recommendation to so lie to the patient, justifying it as being for placebo effect. PPdd (talk) 13:55, 23 February 2011 (UTC)
Someone has already changed it. PPdd (talk) 14:05, 23 February 2011 (UTC)

Thank you for your thoughtful reply, however it seems that I have been unable to make my point clearly. It seems to me that you have been attempting to edit this article to show that alt med/IM take advantage of the placebo effect. But you seem unable to accept the fact that both mainstream and alt med alike are aware of and use the placebo effect. It makes no sense to point our alt meds use of placebo when mainstream "use" it as well. Please see this site: http://www.stfm.org/fmhub/fm2010/October/Rachel636.pdf Gandydancer (talk) 15:42, 23 February 2011 (UTC)

Thank you for pointing out that [6] is a blog. I missed that. While it appears to be a relatively good one, there's no need or justification for using it. The author for the specific post is listed as Stephen Novella, MD, also listed as the founder and editor-in-chief for the blog. Hence we'd have to conclude that it is indeed a self-published source. We can certainly do better. LeadSongDog come howl! 15:52, 23 February 2011 (UTC)
There's also a good recent piece on Webmd.com that's perhaps worth a look.[7] Vitaminman (talk) 15:56, 23 February 2011 (UTC)

There are very good recent reviews on developments in fMRI imaging of the pain response that provide considerable insight into the mechanism of the placebo response. See for instance PMID 21041961 and PMID 20376600. It is clear too that much of this work is dependent on the use of new-generation (>7 Tesla) equipment to achieve higher spatial resolution.(PMID 21041961, PMID 20376603). We can now measure a patient's response to a placebo intervention. The step that has yet to be taken is to quantify these responses for various interventions and measure the relative effects of different forms of placebo intervention. We may yet see (warning:wp:CRYSTAL) that the various interventions hitherto dismissed as voodoo, magic, autosuggestion, etc are not all equal. But we are clearly moving into an era where these things can be measured directly. LeadSongDog come howl! 16:40, 23 February 2011 (UTC)

Wow, Gandydancer. Your link to the study about "real" science MDs and placebos is frightening, and far more serious than any alt med practice. Even if I had very good sources for alt med intentional lying to sell placebos for their effect, I would not put my edit back up. I am now thinking about how best to use your source in the relevant evidence based medicine articles, as it seems to be an incredibly disturbing and notable finding. PPdd (talk) 16:49, 23 February 2011 (UTC)
It's not really that sensational and it's a primary source questionaire, so hardly of much worth at Wikipedia. I'm definitely not defending the practice, but it's nothing new and a very well-known phenomenon. BTW, why all this fuss about the placebo effect? We know it exists in every intervention. So what? That's not news. What makes it controversial in the alt med context is when it is used to sell products that have no proven effect beyond the placebo effect. That's deceptive. Lying to test subjects is a required part of placebo controlled trials, but lying to real patients is wrong on so many levels and many mainstream notable authorities object to such practices. It's not right in mainstream medicine, and it's not right in alt med. -- Brangifer (talk) 20:20, 23 February 2011 (UTC)

If one looks through the placebo article, one sees mention and discussion of "deception" many times, and the ethical dilemma that can damage the doctor-patient relationship. The article is also in Category:Deception, which is quite appropriate. Here's a bit from the lead:

The placebo effect points to the importance of perception and the brain's role in physical health. However, when used as treatment in clinical medicine (as opposed to laboratory research), the deception involved in the use of placebos creates tension between the Hippocratic Oath and the honesty of the doctor-patient relationship.[1] The United Kingdom Parliamentary Committee on Science and Technology has stated that: "...prescribing placebos... usually relies on some degree of patient deception" and "prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS."[2]
Since the publication of Henry K. Beecher's The Powerful Placebo in 1955 the phenomenon has been considered to have clinically important effects.[3] This view was notably challenged when in 2001 a systematic review of clinical trials concluded that there was no evidence of clinically important effects, except perhaps in the treatment of pain and continuous subjective outcomes.[3] ...

So "prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS." Pretty sound advice. -- Brangifer (talk) 20:34, 23 February 2011 (UTC)

Hmm, I wonder how much that varies from prescribing impure placebos? How many NHS funded MDs prescribe antibiotics without ever even ordering a culture? Does the "no alcohol while you're on this" have a larger effect than the drug itself? But this discussion is now way off-topic for the alt med talkpage LeadSongDog come howl! 21:52, 23 February 2011 (UTC)
I got antibiotics for my influenza virus, and then I got well. So it must have worked! Now I'm a believer. :) PPdd (talk) 04:00, 24 February 2011 (UTC)
We might add also that deception takes place only when the prescriber doesn't believe in the effect of the treatment. I've little doubt that most of the alternative types do believe that what they are doing has some "real effect" over and beyond placebo. I may not, but if I'm not the one prescibing it, it's not my ethical problem. Am I to halt the homeopath who DOES believe in the power of homeopathy, simply because I personally do not? The second issue is what to do about things where we "sort of" believe in, as a treatment? Not like homeopathy, but more like (say) fish oil for mild migraines. There are a few small studies in the literature, there is a suggested mechanism which sounds a lot better than homeopathy, and I have a patient or two who swear by it (but I have no way of knowing what that means, because I didn't use a placebo-only pill first), and now what do I do? Is it unethical for ME to recommend fish oil first, for somebody willing to try it, rather than an NSAID or a narcotic? How stong can my recommendation be, without it being untruthful? How skeptical do I need to be, before I violate the Hippocratic oath? (Which, BTW, actually speaks against giving somebody a poison, not lying to somebody about an inactive drug -- so that's one MORE issue). SBHarris 04:18, 24 February 2011 (UTC)
That's two good points you made, Sbharris, plus a third one with a good question. First there is placebo+, or placebo + self fulfilling prophesy. And as to they "do believe" (See my comment just before yours), their belief is held in bad faith. I wrote the bad faith article about that exact phenomenon, and put a section on pseudoscience in it. Unlike deception of others, bad faith may include self deception. The deception of onesself has elements of intention, without necessary intent to deceive others, but which is a result of the self deceipt that leads to these bad faith beliefs. Its a very subtle idea, argued about for centuries. PPdd (talk) 04:59, 24 February 2011 (UTC)
PPdd I'd certainly agree that it is deceptive to use a placebo on an unsuspecting patient. However, it is hard to walk in the shoes of a practicing family physician and there is plenty that they'd discuss only with each other because few others would understand. They have to deal with a few patients that are impossible to deal with - by rights they should be seeing a shrink rather than a medical doctor. As for the "fish oil" problem, I see no reason that one could not mention something that may be helping others if it is not in any way harmful. Gandydancer (talk) 22:02, 24 February 2011 (UTC)
Again, this is off topic, but before dismissing the fish oil as placebo for migraine, I'd digest the review at PMID 12480795. There's a clearly plausible mechanism at work. If the papers are correct, eicosanoids are indirectly vasodilators. See too these sources cited therein as refs 10 and 11:
  • Weber PC, Fischer S, von Schacky C, Lorenz R, Strasser T: Dietary omega-3 polyunsaturated fatty acids and eicosanoid formation in man. In Simopoulos AP, Kifer RR, Martin RE (eds):"Health Effects of Polyunsaturated Fatty Acids in Seafoods." Orlando: Academic Press, pp49–60, 1986.
  • Lewis RA, Lee TH, Austen KF: Effects of omega-3 fatty acids on the generation of products of the 5-lipoxygenase pathway. In Simopoulos AP, Kifer RR, Martin RE (eds):"Health Effects of Polyunsaturated Fatty Acids in Seafoods." Orlando, Academic Press, pp227–238, 1986.

LeadSongDog come howl! 23:24, 24 February 2011 (UTC)

Sure, I said there were small studies and plausable mechanisms. But how much enthusiasm does that (should that?) justify in a clinician? You're sort of getting my point. Fish oil is one of my favorite treatments, because it helps: inflamation, pain, depression, migraine, bipolar disorder, ectopic neurological firing in heart and brain, lowers serum triglycerides dramatically, helps with non-alcoholic steatosis of the liver, etc., etc. Omega-3 fatty acids are present to keep membrances fluid in the cold, and remember are the original ingredient in Chinese cold water snake body oil, aka snakeoil. Which turns out to be even more useful than aspirin, and not as dangerous. Fix yer Rheumatiz, only a 3 dollars a bottle.

Now, I don't think I've hurt anybody with fish oil. And I've probably saved more than one patient from NSAID gastric bleeding (mortality-- ~15,000 people per year, morbidity, ~100,000 hospitalizations per year in the US). But am I deluding myself? Do I care if I'm deluding myself? Are you going to rain on my parade? Must I be less enthusiastic about fish oil, and give patients a fishy stare when I vaguely suggest it *might* be worth trying, and at least isn't harmful... Boy that's a placebo effect killer right there, even if there would otherwise be a placebo effect. You see the problem. Oh, that self-deception, don't you hate it. Rationalists must forge on and give the NSAID, because the studies are larger. And because they don't make fish at Pfizer. SBHarris 00:38, 25 February 2011 (UTC)

Again, way off topic for this article... This sort of info from LSD certainly does show the importance of keeping an open mind. One of the strangest things I've ever seen was using gold leaf to heal diabetic leg ulcers of long standing. The doc read about it somewhere and we covered the extensive wounds with gold leaf (purchased from a craft store), wrapped them up and left them alone for a period of time...it seems to me it was at least a week if not more. When we removed the bandages I could hardly believe my eyes - the gold leaf was no where to be seen but in it's place was beautiful pink tissue covering the wounds! Needless to say, I shall never forget that experience and it has completely opened me to the realization that there is a lot we do not yet understand about how the body heals. Gandydancer (talk) 00:16, 25 February 2011 (UTC)
Where did the gold go? I thought it was inert. Either I'm missing something, or your anecdote is. PPdd (talk) 02:08, 25 February 2011 (UTC)
Steven I wouldn't like to bet about fish oils. As you yourself mentioned here, fish oils sometimes seem to give obvious side effects or exacerbate conditions (see also here). As I understand it, more or less anything that monkeys around with the inflammatory process can give problems, most of the NSAIDs are implicated in raising the chances of heart disease; and this wasn't understood for years. That's why good quality studies are needed.Rememberway (talk) 02:35, 25 February 2011 (UTC)
Studies? Search here: [8] for "Fish_Oil" or "Eicosapentaenoic_Acid" - There have been quite a few done on the stuff. LeadSongDog come howl! 04:23, 25 February 2011 (UTC)

Good Source for Int Med - Institute on Medicine of the National Academies of Sciences & Engineering and National Research Council

  • And this has stuff and is pretty good about the author of that paper, Victoria Maizes, hand picked by Weil. PPdd (talk) 04:15, 24 February 2011 (UTC)

Now lets fill up the article and eliminate the junk (like the stuff I put in it). PPdd (talk) 04:19, 24 February 2011 (UTC)

Ok, those are:

The first is an interesting read. It's a review written by True Believers that makes clear what those beliefs are and might be useful. The second is a practioner-as-celebrity puff piece we shouldn't touch. The third is a hefty work that can be found in major medical libraries. It should prove useful for describing Int Med, though we'll need to be careful about whether its contents are supported in more independent sources. LeadSongDog come howl! 22:30, 24 February 2011 (UTC)

Re: "Puff piece", from WP:BJAODN, "Logical positivism vanished in a puff of logic".
More seriously - There seem to be two different things called "integrative medicine", and this bears on what are "the" beliefs and practices of IM. The first is descibed in the above two ("puff" - three) sources on practices and beliefs of the first kind. The second is what is at osher harvard and osher ucsf, and to a lesser degree at stanford. The first is akin to a kind of delusional psychosis. The latter seems completely rational, especially when all the things once listed here were still up. When I went to ucsf for pain and after I had neural surgery for a ruptured disc, I was given a prescription of hydrocodone. I suspect if I went to the Maizes facility, I might have been recommended to an acupuncturist. So we have a dilemma in that "beliefs and practices" differ incredibly in common usage of "integrative medicine". PPdd (talk) 01:57, 25 February 2011 (UTC)

Use of placebos by MDs

Discussion at #The placebo effect looks like it might be going somewhere a bit broader, but I would like to initiate a limited discussion of whether we should include the statement However, a 2010 survey of family physicians found that 56% of respondents said they had used a placebo in clinical practice as well. Eighty-five percent of respondents believed placebos can have both psychological and physical benefits. (source, full text (pdf); article revision). I have no particular complaint with regards to the source, though WP:PRIMARY, WP:MEDRS, and WP:WORLDVIEW suggest that we should prefer to make a more comprehensive point using multiple sources or a review; 412/970 is actually a pretty respectable response rate for this sort of thing. WP:PROMINENCE, however, is also policy. Why should the article about alternative medicine include a survey of how MDs practice medicine? It is off-topic here. The question of medical ethics raised explicitly by the source and implicitly by the sentence here is way off-topic to this article. Could this be addressed instead by rewording the material leading up to this sentence to avoid implying that MDs never prescribe pure placebos? I do not see such an implication myself, as the key parameter being discussed is that some people recommend doing so instead of doing it as a pragmatic response to calls of fix it with a pill, doc. Please keep this discussion focused on the narrow issue at hand, with broader issues confined to the discussion above or some more appropriate forum. - 2/0 (cont.) 20:23, 24 February 2011 (UTC)

That statement doesn't belong in the alt med article. I am the guilty party who introduced the "CAM deliberately lies to get placebo effect" type stuff into the article. After other editors' pointed out that this is a general practice in medicine, I completely reversed my position and think this whole topic is POV and in no way adds to the alt med article. (But the fact that alt med is often placebo does belong here.) PPdd (talk) 02:14, 25 February 2011 (UTC)

Merge from Integrative medicine

There is a new page at Integrative medicine that is mostly redundant with Alternative medicine but contains a bit of content that should be merged here. We just had a discussion last month (note that the page histories have been swapped) indicating a continued consensus that this topic is best treated at a single page. The original merge discussion a few years back gave a strong consensus for this, but it is possible that consensus has changed. In any event, that page needs a strong WP:MEDRS and WP:NPOV filter applied to it. - 2/0 (cont.) 20:31, 18 February 2011 (UTC)

  • Support merge. CLear WP:CONTENTFORK - Most alternative medicines employ science based medicine to at least some extent; the separate category of "integrative medicine" is just another euphamism like "alternative medicine" was initially supposed to be, to replace "quackery". PPdd (talk) 00:29, 19 February 2011 (UTC)
  • At this time (though I can always be convinced), I strongly oppose such a merger. Certainly, this article needs improvement, as virtually any article of such length and depth would require within two weeks of its creation, and many good suggestions on how to do so were just given in the peer review, but I don't see how you can reasonably claim that this article only contains 2-3 paragraphs of useful content. There's a lot of non-promotional material here that is backed by citations to reliable sources. Where content is overly promotional or biased, it should, of course, be improved, but I don't see how that constitutes grounds for scrapping the whole thing.
Furthermore, it seems clear to me that there is a non-trivial distinction between Alternative medicine and Integrative medicine. Alternative medicine is defined by the NIH as "the broad range of healing philosophies, approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available." In contrast, integrative medicine, as I understand it from this article and UCSF's definition, emphasizes the evidence-based combination of conventional and alternative medicine along with better integration in the health care delivery system in terms of the patient-practitioner relationship and collaboration of care between practitioners in different specialties. Where the scope of the article Alternative medicine is any sort of healing practice that doesn't fall into Western medicine, the scope of the article Conventional medicine is far more limited and distinct, covering specifically the use of clinically tested practices in concert with conventional medicine, and also discussing the healthcare delivery topics that are certainly out of scope in Alternative medicine. The topics are, of course, related, and a "see also" hatnote is appropriate to connect the articles, but I see a large enough distinction here for integrative medicine to support its own article. Also, several major US medical schools (Harvard and UCSF to name two) have established large programs for research and practice in integrative medicine. Surely that merits some consideration from a notability perspective?
Finally, I want to say that I have no particular dog in this fight, and really am not particularly knowledgeable in the subject, minus the research I've done after this article appeared. I found the article while reviewing submissions at WP:AfC and was struck by its depth and breadth of sources, especially as the vast majority of new articles I see are well within the criteria for speedy deletion. As such, I became interested in improving this article. Thus far, I have focused primarily on stylistic issues and copy editing, but sought the peer review precisely on how to get feedback on how to better focus this article and address the promotional material. I would rather do that process in collaboration with other editors, especially editors with greater knowledge of the field than go through the usual drama of debating whether to preserve useful content on Wikipedia. Zachlipton (talk) 01:03, 19 February 2011 (UTC)
  • Comment - Zachlipton, what additional material could there be in an integrative medicine article that should not already be in the alternative medicine article (which includes an integrative medicine section)? PPdd (talk) 02:45, 19 February 2011 (UTC)
Well, just brainstorming and looking through the existing Integrative medicine article, here are some such topics that integrative medicine focuses on that are generally not emphasized in contemporary Western medicine, many of which might be presented in summary style with a "main article" link to other articles: stress reduction/biofeedback techniques (yoga, meditation, etc...), Psychoneuroimmunology, health coaching, environmental medicine, patient centered care, the use of integrated teams of specialists to coordinate care (Disease management (health)), interdisciplinary health research, integrative approaches to pain management (combining pharmacology with other techniques), health psychology and behavioral changes, health education, workplace health improvement initiatives, overall wellness promotion, and preventative medicine. In addition, an integrative medicine article could discuss the history of the term and movement, its connections to and distinctions from alternative medicine, major institutions and research organizations (e.g. the Osher centers), and fellowships and training programs in integrative medicine. That seems like a fairly deep article to me, not 2-3 paragraphs.
Integrative medicine seems to be about more than just alternative medicine. For instance, according to the summary section of the report of the Institute of Medicine Summit on Integrative Medicine, "care coordination that emphasizes wellness and prevention" is "a hallmark of integrative medicine." And I don't simply mean coordination between the doctor and an acupuncturist, this is discussed in the context of transitions like those "from hospital to home care." This page from the summary (the report states it was prepared by independent rapporteurs of the IOM as an summary of the views expressed at the Summit) lists some of the major areas participants viewed as part of integrative medicine. Alternative medicine is a relatively small part. Now, one might well say that the topic of integrative medicine is simply too broad and/or vague and it's more of a fancy term for "practice good medicine and make/keep people healthy," but the main focus seems to be on integrating different parts of the entire health and wellness field to best serve patient needs as an alternative to the uncoordinated "find-it-and-fix-it mentality" (IOM Summary pg. 11) common in Western symptom-diagnosis-treatment medicine.
It is clear that integrative medicine's supporters, rightly or wrongly, are establishing it as a distinct academic field separate from alternative medicine as they have moved away from Andrew Weil and related advocates. This can be seen by the establishment of integrative medicine programs at Harvard, UCSF, Duke, Scripps and Sloan-Kettering, among others. I don't want to promote quackery and I think the article needs to be honest and frank about both the good and bad in integrative medicine. In particular, I think it needs to focus primarily on rigorous reviews and not individual study results, and I don't doubt there are a number of alternative medicine quacks who desire to legitimize their fields through the label of integrative medicine, but that's a separate issue from the question of merger. Going back to the definitions, integrative medicine is a style of medicine and area of clinical research that includes, among other things, evidence-based alternative medicine. Alternative medicine is simply all healing practices outside of conventional medicine. The former is a philosophy of medicine and area of academic research, while the latter is a catch-all collection of stuff. Zachlipton (talk) 05:15, 19 February 2011 (UTC)
Thanks for the good faith thinking. But all of the example you cite are example of specialized fields of science based medicine. If you take any specialized group of fields in science based medicine, you could say that science based medicine does not focus on them. For example, my girlfriend at stanford was a psychologist doing your first example, psychoimmunology. She was doing science based medicine, and would scoff at the suggestion that it was "integrative". Or cancer research, which "integrates" environmental, diet, etc. medicines. Certainly cancer research should not be put under the heading of integrative medicine. Heart disease research similarly focuses on overall lifestyle, and integrates diet, excercise, psychological stress, the environment, etc. But this is not "integrative medicine". The hallmark of integrative madicine is that it implements alternative medicine, hence the label "quackademic medicine", now a standard term in most university medical schools. PPdd (talk) 21:53, 20 February 2011 (UTC)
  • Support merge. There has been no significant change of the definition of "integrative medicine" since our last decision to merge the two. Integrative medicine is basically a definition of how alternative medicine methods are used in a mainstream medical setting by those physicias who choose to use such techniques and methods. The techniques are exactly the same, it is only the setting that is changed. The definition can easily be incorporated here and take up no more than a paragraph. If it is deemed necessary to enlarge it to 2-3 paragraphs in its own section, that can also be done here. -- Brangifer (talk) 02:19, 19 February 2011 (UTC)
Comment - I just started an integrative medicine section in alt med, and also a simple subsection for criticism unique to integrative medicine as distinct from alternative medicine. PPdd (talk) 02:47, 19 February 2011 (UTC)
I like having a section on history of the term integrative medicine (to go wherever the Weil material ends up), but I think academic alternative medicine is really just part of the story of the growth in popularity of alternative medicine. For instance, someone donating $37M to a hospital to build a center for integrative oncology is not really the same as a school of chiropractic trying to merge with a medical school. - 2/0 (cont.) 04:10, 19 February 2011 (UTC)
I started a history subsection (but did a very poor job, I just copied the two RS sentences from the IM article). PPdd (talk) 19:10, 21 February 2011 (UTC)
  • Copyvio alert - the original was closely paraphrased from [9]; the source and its sources might be usable after checking, but I will be gutting the copied material if the article has been edited too much to qualify for speedy. If anyone is merging material from that article to this one, please check it against that link or reword it from your sources. - 2/0 (cont.) 05:54, 19 February 2011 (UTC)
Your tagging Integrative medicine for speedy deletion as a copyvio really doesn't seem to advance the discussion process here. CSD G12 is only for "unambiguous copyright infringement," but certainly the vast majority of the Integrative medicine article bears no resemblance to the page you linked. I see some copying in the "Cost Effectiveness" section, which is a very small portion of the article. Surely you could have followed standard procedure and just blanked the relevant content and posted a notice? In any case, the authors of that document appear to dedicate most of their content to the public domain (I did not know this, but just found this on google), which would avoid the issue entirely (though text should obviously be properly attributed anywhere it's not and NPOV ensured). I'd rather discuss the issue here instead of trying to delete the entire article. Zachlipton (talk) 06:04, 19 February 2011 (UTC)
  • Support merge. II | (t - c) 19:51, 19 February 2011 (UTC)
  • Strongly oppose It would make much more sense to include alt med in integrative med, but I don't expect to see that happen. Thus I believe it should have its own article as it is quite a separate entity. Integrative med stresses a holistic approach to health care. It urges the patient to use the approach that best helps to promote healing. Generally that means mainstream medical approaches, but often complementary practices (and less frequently even alternative methods) are advised as well. Just this morning, watching the "Today" show on TV, they interviewed an individual from an Integrative Medicine group to refute the latest miracle cancer cure. Our local TV evening shows (Portland, Maine) frequently interview individuals involved in complementary medicine - and they don't snicker either. I sometimes feel that the small group that controls this article is stuck in the past while the rest of the world is moving forward. Gandydancer (talk) 21:33, 20 February 2011 (UTC)
Comment - Gandydancer, please cite an example of information that would be in the integrative medicine article, which is not or should not be in the alternative medicine article.Also, science based medicine also stresses on a holistic approach, such as stress reduction, diet, and health recommendations, so what exactly would be in the integrative medince article that is not covered in the alternative medicine article, beyond alternative medthods used, or used to supplement, science based medicine? PPdd (talk) 21:42, 20 February 2011 (UTC)
I think the "stress reduction, diet, exercise" (and maybe call in your priest/minister/rabi/medicine man also) is something medicine pays lip service to, mostly without the kind of strong level I or II evidence required by the EBM approach. Worse still, when a "kitchen sink" of stuff works (think the Ornish program) "science-based medicine" has no way of telling which parts of it were the essential parts, or if there was some synergistic effect. For example, can you leave out the meditation part of the Ornish program, or not? Where is the placebo-controlled study of the benefits of meditation, or for that matter, of exercise? (And how did you do that study??) The thing about EBM is that it contains a lot of separated-out stuff that we have very good evidence for, and then there's ALSO a whole lot of stuff that makes sense that we really don't have good Level I EBM evidence for (but have some evidence as parts of programs or epidemiologically), and that level II stuff and even some level III, is what we add in and now call IM or "integrative medicine" (which is a lot of EBM level I, II, III plus social work and psychiatry, which is to say, the average practice of traditional medicine as it's usually done, not as Dr. House on TV would do it). Alternative medicine tends to leave any anything EBM I or II, and to be a grab bag of specific techniques, some of which are used in IM, and others of which would never even get to EBM level III because nobody believes in them mechanistically (crystal healing, energy healing, homeopathy, etc). Perhaps even chiropractic and acupuncture, which would have been in IM 20 years ago, but which are now starting to drift toward alternative stuff that EBM-lovers don't consider as worthy candidates for an IM approach (especially if they take the place of things we consider have more chance of doing mechanistic good). This is a spectrum of stuff in which it is hard to draw lines. Not surprisingly, because it involves induction, and thus it's all the set of continuous probabilities, from good to bad. Place your bets. SBHarris 00:19, 21 February 2011 (UTC)
  • Strongly Oppose. It is clear that Integrative Medicine, while potentially involving alternative medicine, is not at all reliant on it. Based on my understanding, an integrative treatment plan could potentially include only non-alternative medicine, depending on the individual. Putting Integrative medicine under Alternative Medicine would be similar to merging an article on common sources of dietary protein into the meat article.129.10.188.176 (talk) 13:11, 22 February 2011 (UTC)
  • Comment. That's nonsensical. The very definition makes it clear that it is alternative medicine (AM) techniques and methods that are being "integrated". You can't just make up definitions or change them. The whole basis for the existence of IM is to legitimize the use of AM in mainstream medical settings. The wording of IM's definition is deceptive, since if it's proven, it's no longer "alternative" but "medicine". To make matters worse, in practice almost any method, no matter how ridiculous or disproven, is being used in so-called "integrated" settings and those who run them claim they are practicing IM or CM. -- Brangifer (talk) 16:49, 22 February 2011 (UTC)
I would support Brangifer's clear statement of this point, but instead, being in a facetious mood, I will instead point out that "dietary protein" is not even mentioned in the meat article. :) PPdd (talk) 22:41, 22 February 2011 (UTC)
  • Strongly Oppose. Alternative medicine should be a subsection of Integrative Medicine and not the other way around. As defined by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, integrative medicine "combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness."(SLSQK (talk) 18:50, 22 February 2011 (UTC)) Confirmed sock of User:Bravewell

— SLSQK (talk • contribs) has made few or no other edits outside this topic.

  • Its hard to tell what is truly considered seriously important around here. Did you just make an "argument from my father can beat up your father"? :) PPdd (talk) 22:44, 22 February 2011 (UTC)
  • SLSQK, your opinion doesn't really address the subject here. We know the definitions of the words. Repeating them here doesn't help us. -- Brangifer (talk) 00:33, 23 February 2011 (UTC)
  • Strongly Oppose Integrative Medicine is entirely different from Alternative Medicine. Integrative Medicine constitutes a whole philosophy of care. Please see websites for University of Arizona Center for Integrative Medicine, the American Academy of Pain Management, the Consortium of Academic Health Centers for Integrative Medicine and the IOM summit on Integrative Medicine. One of the main principles is that all the influencers of health disease -- mind, body, environment, etc -- are addressed in the care. It is not so much about "what therapy" is used to address those influencers, but that they are addressed. Further, Integrative Medicine is practiced by conventionally degreed practitioners -- MDs, RNs, PhDs, etc. Alternative medicine refers to those medical systems different from our own such as TCM, Ayruvedic Medicine etc. which have their own credentialing processes. Sometimes alternative medicine interventions are used in Integrative Medicine and sometimes they are not. Additionally, if they wanted to, people could practice Alternative Medicine in a non-integrative way. The two terms are simply not interchangeable. They mean different things. — Preceding unsigned comment added by Bonniehorrigan (talk • contribs) 21:30, 22 February 2011 (UTC)

— Bonniehorrigan (talk • contribs) has made few or no other edits outside this topic.

  • Bonnie, your opinion doesn't really address the subject here. We know the definitions of the words. Repeating them here doesn't help us. -- Brangifer (talk) 00:33, 23 February 2011 (UTC)
  • Strongly Oppose Even a passing acquaintance with the English language, let alone any well-written dictionary, ought to be sufficient to show any editor worthy of the name that integrating with something is not the same as purporting to provide an alternative to it. Vitaminman (talk) 00:13, 23 February 2011 (UTC)
  • Vitaminman, your opinion doesn't really address the subject here. We know the definitions of the words. Repeating them here doesn't help us. -- Brangifer (talk) 00:33, 23 February 2011 (UTC)
  • Many people here clearly feel the same about your opinions, BullRangifer, so please stop repeating the same text and arguments. We are all very clear what your opinions are on this issue. Vitaminman (talk) 13:15, 23 February 2011 (UTC)
  • ??? My comments address the issue. I'm not complaining about your opinion, but that what you and others have expressed doesn't count here because it doesn't address the issue. That's the way this works. It's not a "vote", and the strength of the arguments is what counts, and none of you have really addressed the situation, only repeated well-known definitions. -- Brangifer (talk) 20:08, 23 February 2011 (UTC)
Again, this is simply your opinion. More to the point, despite the fact that you are clearly desperate to portray it as otherwise - seemingly so that the Strongly Oppose votes are not counted - your opinion is worth not one jot more than any other opinion stated here. Your opinion does count, but so do the opinions of all the other editors taking part in this discussion. Vitaminman (talk) 21:49, 23 February 2011 (UTC)
  • Comment Is there any difference between complementary and alternative medicine and Integrative Medicine? AIRcorn (talk) 07:27, 27 February 2011 (UTC)
"Alternative medicine is any healing practice that does not fall within the realm of conventional medicine,[1] or that which has not been shown consistently to be effective." from the leade first sentence. Integrative medicine integrates alt med into evidence based med. So Int med does not fall within the realm of conventional medicine. So Int med is an alt med. So there is no difference. PPdd (talk) 02:29, 9 March 2011 (UTC)
Sorry I meant between CAM and integrative medicine. Reading the IM article it talks about a holistic approach and I thought CAM was about using alternative medicine alongside conventional medicine[10], which seems like the smae thing unless there are any other medicines. If it is deemed close enough then it should probably be merged into here until a consensus to re-create a CAM/IM article emerges. AIRcorn (talk) 13:38, 29 March 2011 (UTC)

Alt med is a medicine that parts that did not work when tested, or are untested. Integrative medicine claims it is alternative medicine integrated into evidence based medicine. But that means IM has parts that don't work or are untested, so IM is an alt med. So there is no difference between IM and alt med. PPdd (talk) 02:25, 9 March 2011 (UTC)

This definition[11], taken from The News-Star, the principal newspaper of Monroe and northeastern Louisiana, concurs with the same common-sense definitions of complementary medicine and alternative medicine that I have always adhered to: Complementary medicines are used together with conventional medicine, while alternative medicines are used in place of conventional medicine. Vitaminman (talk) 12:51, 4 April 2011 (UTC)
And for integrative medicine, this definition[12] from the BMJ is as good as any that I've come across: Integrated medicine (or integrative medicine as it is referred to in the United States) is practising medicine in a way that selectively incorporates elements of complementary and alternative medicine into comprehensive treatment plans alongside solidly orthodox methods of diagnosis and treatment. Vitaminman (talk) 12:55, 4 April 2011 (UTC)

Closing

I am closing this proposal by removing the merge tag from the integrative medicine article. The discussion seems to have died down without any consensus to merge (i.e. no merge actually occurred). Accordingly I don't think it needs a complete rationale, but for the record there are some strong, well-thought arguments on both sides, and an outcome not to merge is supportable by the argument that though related and probably overlapping, integrative and alternative medicine are two different subjects so separate material can reasonably be maintained in articles on each. - Wikidemon (talk) 23:40, 8 June 2011 (UTC)

Attention needed at Osteopathy

Attention is needed at the Osteopathy article per this. PPdd (talk) 05:33, 1 March 2011 (UTC)

Stress

A publication produced in association with the British Medical Association recommends several CAM to deal with stress.Could mention in the Education section.Oxford73 (talk) 09:39, 1 June 2011 (UTC)

Alt med self describes itself as science, using wording from def of pseudoscience

On this or the pseudoscience talk page there was an objection to calling sicint the alt med TCM as being "pseudoscience", arguing that it soes not claim to be science. But here is a quote from a very prominent TCM historian/practitioner -

"detailed practical instructions that make Chinese medicine a science... whether modern laboratory verification has been able to perceive any benefits or not"

And here is almost the exact same structure with the words generalized in the definition of pseudoscience -

"Pseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific methodology."

Here is the full quote -

"It is further said in the oral traditions of the Fire Spirit School that the seedlings of aconite (“Traditional_Chinese_medicine#Aconite_root

— The King of TCM Herbs]]” and the “Queen of Poisons”) need to be harvested high in the mountains where they endure great cold—maybe this is why this herb is so powerful in driving out damp cold—-and then should be planted at the winter solstice in the Jiangyou area among other crops. The aconite plant then grows in the time of year when the yang is in its ascendancy and is harvested at the summer solstice before the yang starts its decline. This herb thus very literally absorbs only the energy of the yang part of the year. This attention to timing is important, but most growers now disregard this key feature. I believe very strongly that it is these types of detailed practical instructions that make Chinese medicine a science in its own right, and that it is important that they be heeded, whether modern laboratory verification has been able to perceive any benefits or not. The principle that involves herb cultivation in the right place and harvesting at the proper time of year is called didao yaocai. This term means “genuine,” and expresses the proper yin and yang properties of the herbs due to correct attention to planting in the right place (di: yin) at the right time (dao: yang). Only then can this herb considered to be genuine. It is not just a matter of correct species identification.[13]"

Interestingly, the quoted person is a historian of the oral tradition, and make his assertions in oral interviews, so it is still a secondary source, but marginally so under WP:RS. An objection per RS might be that he qualified it with a "I believe that...", but his belief is clearly intended to carry the authority of an assertion about the primary sources he is describing, and is only worded with "believe that" as a characteristically modest style of that tradition. Another objection is that connecting the two is OR or Synthy, but that defies WP:Common sense, and would force anything on WP to be an exact quote. So such objections would be somewhat WP:POINTy. PPdd (talk) 23:26, 9 March 2011 (UTC)

Do you have additional sources that assert TCM is a science (e.g. textbooks TCM practitioners use in their training)? I'm asking because even if this historian is a prominent practitioner, that doesn't mean that his opinions have to represent the mainstream of his practice. I was under the impression that most TCM practitioners consider themselves empiricists. --Six words (talk) 23:45, 9 March 2011 (UTC)
No, I don't. I looked a bit when it came up here (or at pseudoscience, I don't rememeber), but I never outright found any RS saying - "we are science", or much better - "they say they are science". I was responding to a SP/MP attack from a facebook alt med "professor" group who did not like the TCM article, and looking for RS sources for both the astrology (feng shui) content that was in that article when I came to it, and I was looking for RS re the history of aconite (Queen of Poisons), and I happened across this. I was stunned at the sililarity with the WP definition of pseudoscience. It read more like one of my sarcastic jokes based on a WP item, than a real assertion. I did not quite know how to handle an oral interview of an historian of oral tradition who is also semi-worshipped by TCM, and I liked the near identity in form of his words with the pseudoscience lead definition, which, of course is not RS either, both since it is Synth and since WP is not RS. If nothing else, it is an interesting talk page curiosity, for the assorted reasons I stated re RS. PPdd (talk) 01:58, 10 March 2011 (UTC)

I am sorry but do you have a grasp of basic set theory? This is the "alternative medicine" article. TCM is usually grouped within that category. Now you say you present evidence that "TCM is pseudoscience". Well, then why do you bring it up instead of at Talk:Traditional Chinese medicine? How does it follow that an umbrella term is "pseudoscience" if you can show that one of its sub-branches is "pseudoscience"?

It is obvious, I hope, that the term "alternative medicine" includes a wide field of approaches, some of which are clearly pseudoscience. But it also includes others which are either not clearly pseudoscience, or clearly not pseudoscience. It follows that the "pseudoscience" category is misplaced here. It's like, say, slapping The template Category:Carnivorans on the Mammals article, because obviously some mammals are Carnivora. --dab (𒁳) 12:08, 12 July 2011 (UTC)

Agreed, your argument is rational and absolutely correct. Unfortunately, however, most of the higher profile WP alt med pages tend to be dominated by people who are intent on maintaining the scientific status quo, and this one is no exception. Vitaminman (talk) 18:50, 12 July 2011 (UTC)

Western culture?

Seems we have a dispute over starting the article with "In Western culture...". It is ... any healing practice "that does not fall within the realm of conventional medicine" globally speaking - not limited to western. Much of it originated in western cultures as folk medicine where "conventional or science based medicine" was unavailable. So we need to drop the "western culture" bit unless it can be supported as commonly used by reliable sources. Vsmith (talk) 01:46, 14 May 2011 (UTC)

Disagree with your POV, but agree that this needs a WP:RS to support it. Traditional Chinese medicine and, in India, Ayurveda, have existed for thousands of years. Moreover, they remain highly influential in those countries, and indeed throughout much of Asia, despite Western medicine having essentially classified them as systems of complementary and alternative medicine. In short, it would be grossly inaccurate to pretend that what Western culture has itself classified as alt. med. actually originated in Western cultures. Vitaminman (talk) 07:25, 14 May 2011 (UTC)
So we now open the article with the medical expertise of a Missouri folklorist, a blogger, Richard Dawkins, a self-proclaimed medical quackary expert, and now a quote from a mostly unknown author who may or may not have been referring to Western medicine in his quote. Gandydancer (talk) 14:48, 17 May 2011 (UTC)
Yes, hardly inspires confidence in the article being a reliable source of information on alt med, does it? Still, since we have plenty of doctors contributing here, they must know what they're doing, right? ;-) Vitaminman (talk) 17:00, 17 May 2011 (UTC)
The Missouri Folklore does not seem to be the most reliable source. Even in some branches of conventional medicine treatments are not always consistently effective?Oxford73 (talk) 13:30, 26 May 2011 (UTC)
You may find this editorial (and the follow-ups) interesting. http://www.bmj.com/content/339/bmj.b5351.full ALL medications/treatments should be looked at with both eyes open and an open mind. And always keep in mind that the medical/drug lobbyists by far outnumber our congressional representatives.Gandydancer (talk) 23:43, 26 May 2011 (UTC)
Is there a case for deleting that second definition in the characterisation section as the source does not seem that reliable?Oxford73 (talk) 05:29, 27 May 2011 (UTC)
Oh my, I'm afraid you are a babe in the woods as I once was on this article. I attempted to remove this statement and all hell broke loose. You can read the discussion in the archives starting January 2010. I'd say that this article is an example of Wikipedia at its worst. The negative aspects of CAM could easily be reported without resorting to manipulation of information. For instance, most articles insist on using information from a large review such as Cochrane, while this one argues that "Dr. Davis" (who as it turned out is actually a doctor of English, mot medicine) trumps a Cochrane review. Gandydancer (talk) 11:24, 27 May 2011 (UTC)
I've removed it on the grounds that the text and citation was not consistent with WP:MEDMOS. Whilst I fully expect that the usual suspects will quickly reinstate it, albeit on spurious grounds, the point has to be made that some of us here expect better than this.Vitaminman (talk) 20:16, 27 May 2011 (UTC)

Well, Hope springs eternal I guess. There is still Dawkins, the Australian comic, and so on. If you are correct on this one, how could these others still be acceptable?.Gandydancer (talk) 21:03, 27 May 2011 (UTC)

The others are not acceptable either, of course. But I see Orange has already reverted my edits, pretending they were "POV deletions". The fact that he did so without even bothering to come here, to explain his personal POV, speaks volumes. Vitaminman (talk) 07:09, 28 May 2011 (UTC)
What is the relevant archive number.Oxford73 (talk) 11:58, 28 May 2011 (UTC)
If someone just reverts the edits without discussion is there no way of challenging this or going to arbitration?Oxford73 (talk) 08:16, 29 May 2011 (UTC)

Here is my post from when I deleted Dr. Davis:

I do not feel that it is correct to open the article with a statement by a person who, as far as I can tell, is not qualified to make a judgment on CAM. If someone has more information on Dr. Davis, I'd like to see it, since when I google him I come up with next to nothing. On the other hand, the well known Cochran group says something quite different to define CAM:

What are considered complementary or alternative practices in one country may be considered conventional medical practices in another. Therefore, our definition is broad and general: complementary medicine includes all such practices and ideas which are outside the domain of conventional medicine in several countries and defined by its users as preventing or treating illness, or promoting health and well-being. These practices complement mainstream medicine by 1) contributing to a common whole, 2) satisfying a demand not met by conventional practices, and 3) diversifying the conceptual framework of medicine."[17]

Furthermore, if one were to use the statement, "that which has not been shown consistently to be effective" one would need to include some mainstream drugs, antidepressants, for just one example. Thoughts? Gandydancer (talk) 15:36, 24 January 2010 (UTC)

And the reply I got:

Gandydancer, you're throwing our "not noteworthy" quite a bit. By whose definition? Are you engaged in whitewashing by removing critical POV? If they're sourced properly, then your personal opinion needs to be weighed against the opinions of lots of other editors before you start deleting sourced material. That's normally considered vandalism. You have been bold and removed material. That it was sourced is problematic, so you shouldn't have done it. But since you were reverted (twice!) and stil persisted, that's a violation of the WP:BRD cycle. It only has one cycle. You should have immediately, right after the first restoration, started this discussion. It's good you're doing it now and we might we get somewhere with this.

Ludwigs, I reverted one of your deletions as we don't delete POV here, especially when properly sourced. If the wording could be made better, as well it might, then let's discuss it here first.

As you know, this article has been a war zone many times and we need to avoid returning to those days. It can certainly be improved, so suggestions are always welcome. I'm not saying that your objections might not have legitimacy. I'm just saying that we should discuss it first. -- Brangifer (talk) 05:15, 25 January 2010 (UTC)

Just for the record, I did not revert twice. I reverted once and asked for a discussion. Eventually the problem was ended with Dr. Davis appearing not only in the lede but in the body of the article as well. So it goes. Gandydancer (talk) 08:53, 29 May 2011 (UTC)

What gives? After the "all hell broke lose" incident I mentioned above, on July 8 an anon removed the English professor Dr. Davis definition from the lede and there was complete silence - no threats...nothing! I long ago quit trying to make any edits on this article because certain editors feel that it's OK to break all the rules if you just don't like something. You'd think that people were dropping dead in the streets and it was up to a handful of Wikipedia editors to snatch them from the evils of alt med. If that attitude has changed, I do welcome it! Gandydancer (talk) 00:15, 15 July 2011 (UTC)

shamanic healing method

Shamanic healing methods employ a creative visualisation technique. They involve hunting the visualisation of the disease,quite often a worm, pulling that worm from the body and destroying it either by my twist and rip apart or conflagation which are my two alternatives. Be aware that fighting your disease is a fight and the harder one visualises it's destruction the faster one heals. — Preceding unsigned comment added by Maha-ete (talk • contribs) 06:52, 29 July 2011 (UTC)

contradictory claims in the lead

Regardless of their factual basis the claims made in the following two quotes taken from the lead do contradict each other,

"The claims made by alternative medicine practitioners are generally not accepted by the medical community because evidence-based assessment of safety and efficacy is either not available or has not been performed for these practices."

and

"Unlike mainstream medicine, CAM often lacks or has only limited experimental and clinical study; however, scientific investigation of CAM is beginning to address this knowledge gap."

because a) "generally not accepted" does not mean the same thing as "has only limited experimental and clinical study" and because b) the first does not address the fact, addressed the second quote, that some of these claims are being investigated and may soon become facts.

I suggest that we remove the first quote mostly because it is redundant. Four out of five of the paragraphs in the lead are about this topic, namely how mainstream medicine is more credible than alternative medicine. I would also suggest removing the first quote from the lead because it is probably factually incorrect since the second quote that it contradicts is a direct quote from a report prepared by the White House Commission on Complementary and Alternative Medicine. makeswell (talk) 07:04, 7 August 2011 (UTC)

They are not contradictory. CAM modalities are not accepted because they don't have significant experimental evidence on which to base support. You actually have to show something works before it can gain widespread acceptance. CAM fails this. Yobol (talk) 12:31, 7 August 2011 (UTC)
If you haven't studied something then you don't know if it works or not. How can I tell you if there are gremlins on the moon if I've never been there. The same applies here: it's impossible to know whether the claims made by CAM medicine are true or not because they haven't been fully studied. makeswell (talk) 19:17, 7 August 2011 (UTC)
P.S. Sorry if I didn't make that clear in the beginning. makeswell (talk) 19:17, 7 August 2011 (UTC)
the first blockquoted sentence above states that, "the claims... are generally not accepted," and thus implies that the general medical community does know the claims are false. the sentence continues, "because evidence-based... is... not available," and thus implies there's a lack of knowledge about whether or not the claims are true. it is impossible to both not know if some claim is true or false and to also know the claim is false. therefore the sentence is self-contradictory.
regardless, even if we reworded the sentence, still it remains the fact that the lengthy lead is composed primarily of repetition. since the first blockquoted sentence above basically repeats the second blockquoted sentence above, we might as well remove the first and keep the second.makeswell (talk) 19:30, 7 August 2011 (UTC)
Unfortunately, Makeswell, you're missing the point here. The fact that the lead is lengthy and composed primarily of repetition is entirely intentional. In fact, the whole purpose of this article seems now to be to undermine the credibility of alt. med. To the people who are mainly responsible for the lead, therefore, it matters not one jot that the content repeats itself endlessly. Instead, a key goal is simply to ensure that it is as difficult as possible to remove it. As such, whilst I would fully agree with anybody who feels that this article is hopelessly biased, the reality is that the deck has intentionally been stacked against anyone who tries to restore the balance. Vitaminman (talk) 20:56, 7 August 2011 (UTC)
The burden of proof is on the people claiming efficacy or safety. Acceptance is based on the positive evidence of efficacy and safety. I fail to see where there is a contradiction here. Lack of evidence will always lead to lack of acceptance. Yobol (talk) 21:08, 7 August 2011 (UTC)
Perhaps, Yobol, but you're avoiding the fact that the lead is lengthy and composed primarily of repetition. Whilst I realize that this is the way alt. med. articles are designed on WP, my point is that this is neither helpful to the reader, nor necessary. Vitaminman (talk) 09:02, 8 August 2011 (UTC)
First it's contradictory, now it's saying the same thing too much. Someone make up your mind. I see no repetition or contradiction, btw. Yobol (talk) 14:58, 8 August 2011 (UTC)
I agree with your statement Yobol that, "lack of evidence will always lead to lack of acceptance," or something like that. But lack of evidence doesn't lead to the presence of rejection which is what the article says. There's a difference between not claiming that a belief is true and claiming that a belief is false, or 'lack of acceptance' and 'presence of rejection'. Same point - there's a contradiction. makeswell (talk) 07:38, 13 August 2011 (UTC)
Don't see any contradiction. You have to prove it works before it can be accepted. If it is not proven to work, it will not be accepted. Yobol (talk) 04:03, 15 August 2011 (UTC)

I agree. But, the quote from the lead states that claims from CAM are, "generally not accepted," and therefore implies (potentially) that the claims are thought of as untrue rather than their truth values being unknown. We could rephrase this to state clearly that there simply enough known about CAM claims to prove or disprove them, but that information is already stated four times in the lead, as shown in the four quotes taken from the lead and shown below,

  • "Unlike mainstream medicine, CAM often lacks or has only limited experimental and clinical study; however, scientific investigation of CAM is beginning to address this knowledge gap."
  • "...rather than a scientific (i.e. evidence-based) basis."
  • "The claims made by alternative medicine practitioners are generally not accepted by the medical community because evidence-based assessment of safety and efficacy is either not available or has not been performed for these practices."
  • "Because alternative techniques tend to lack evidence, or may even have repeatedly failed to work in tests, some have advocated defining it as non-evidence based medicine, or not medicine at all."

I think that the lead is too redundant and we should probably abbreviate it. What do you all think we should do? makeswell (talk) 03:38, 17 August 2011 (UTC)

But, reading some of the studies referenced on Alternative Medicine, it seems some of the studies have shown that no real benefits come from certain types of alternative medicine. For instance one reference, [14], describes how studies have shown how no real benefits come from doing acupuncture. Perhaps it is the fourth of the above quotes, "...alternative techniques tend to lack evidence, or may even have repeatedly failed to work in tests...," that most well defines the current state of research on alternative medicine. Thoughts? makeswell (talk) 03:50, 17 August 2011 (UTC)

Rewriting the lead

Please give your input about what you think we need to do in regards to the lead. Please provide specific suggestions about direction you would like to take. Please format any new and distinct topics as subheadings. Thanks.

The original lead:

Alternative medicine is any healing practice "that does not fall within the realm of conventional medicine".[1] In some instances, it is based on historical or cultural traditions, rather than a scientific (i.e. evidence-based) basis. Critics assert that the terms “complementary” and “alternative medicine” are deceptive euphemisms meant to give an impression of medical authority.[2][3][4]
It is frequently grouped with complementary medicine or integrative medicine, which, in general, refers to the same interventions when used in conjunction with mainstream techniques,[5][6][7] under the umbrella term complementary and alternative medicine, or CAM. Some researchers in alternative medicine oppose this grouping, preferring to emphasize differences of approach, but nevertheless use the term CAM, which has become standard.[8][9] "Although heterogeneous, the major CAM systems have many common characteristics, including a focus on individualizing treatments, treating the whole person, promoting self-care and self-healing, and recognizing the spiritual nature of each individual. In addition, many CAM systems have characteristics commonly found in mainstream healthcare, such as a focus on good nutrition and preventive practices. Unlike mainstream medicine, CAM often lacks or has only limited experimental and clinical study; however, scientific investigation of CAM is beginning to address this knowledge gap. Thus, boundaries between CAM and mainstream medicine, as well as among different CAM systems, are often blurred and are constantly changing."[5]
Alternative medicine practices are as diverse in their foundations as in their methodologies. Practices may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, or newly conceived approaches to healing.[10] Jurisdictions where alternative medical practices are sufficiently widespread may license and regulate them. The claims made by alternative medicine practitioners are generally not accepted by the medical community because evidence-based assessment of safety and efficacy is either not available or has not been performed for these practices. If scientific investigation establishes the safety and effectiveness of an alternative medical practice, it then becomes mainstream medicine and is no longer "alternative", and may therefore become widely adopted by conventional practitioners.[11][12]
Because alternative techniques tend to lack evidence, or may even have repeatedly failed to work in tests, some have advocated defining it as non-evidence based medicine, or not medicine at all. Some researchers state that the evidence-based approach to defining CAM is problematic because some CAM is tested, and research suggests that many mainstream medical techniques lack solid evidence.[13]
A 1998 systematic review of studies assessing its prevalence in 13 countries concluded that about 31% of cancer patients use some form of complementary and alternative medicine.[14] Alternative medicine varies from country to country. Edzard Ernst says that in Austria and Germany CAM is mainly in the hands of physicians,[9] while some estimates suggest that at least half of American alternative practitioners are physicians.[15] In Germany, herbs are tightly regulated, with half prescribed by doctors and covered by health insurance based on their Commission E legislation.[16]

One possible revision of the original lead:

Alternative medicine is any healing practice "that does not fall within the realm of conventional medicine".[1] In some instances, it is based on historical or cultural traditions, rather than a scientific (i.e. evidence-based) basis.
A 1998 systematic review of studies assessing its prevalence in 13 countries concluded that about 31% of cancer patients use some form of complementary and alternative medicine.[14] Alternative medicine varies from country to country. Jurisdictions where alternative medical practices are sufficiently widespread may license and regulate them. In Austria and Germany CAM is mainly in the hands of physicians,[9] while in America some estimates suggest that at least half alternative practitioners are physicians.[15] In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance based on their Commission E legislation.[16]
Alternative medicine is frequently grouped with complementary medicine or integrative medicine, which, in general, refers to the same interventions when used in conjunction with mainstream techniques,[5][6][7] under the umbrella term complementary and alternative medicine, or CAM. Some researchers in alternative medicine oppose this grouping, preferring to emphasize differences of approach, but nevertheless use the term CAM, which has become standard.[8][9] Critics assert that the terms “complementary” and “alternative medicine” are deceptive euphemisms meant to give an impression of medical authority.[2][3][4]
Alternative medicine practices are diverse in their foundations and methodologies. Methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, or newly conceived approaches to healing.[10] "Although heterogeneous, the major CAM systems have many common characteristics, including a focus on individualizing treatments, treating the whole person, promoting self-care and self-healing, and recognizing the spiritual nature of each individual. In addition, many CAM systems have characteristics commonly found in mainstream healthcare, such as a focus on good nutrition and preventive practices. Unlike mainstream medicine, CAM often lacks or has only limited experimental and clinical study; however, scientific investigation of CAM is beginning to address this knowledge gap. Thus, boundaries between CAM and mainstream medicine, as well as among different CAM systems, are often blurred and are constantly changing."[5]
Claims about the efficacy of alternative medicine tend to lack evidence, and may have even been shown to repeatedly fail during testing. Some researchers state that the evidence-based approach to defining CAM is problematic because some CAM is tested, and research suggests that many mainstream medical techniques lack solid evidence.[13]
makeswell (talk) 04:33, 17 August 2011 (UTC)

Removing the two sentences beginning with, "The claims made by..."

I think it is a good idea to remove these two sentences (shown in the third bullet below) because the topic of how little studies have been done on CAM is currently repeated four times in the lead, as quoted below,

  • "Unlike mainstream medicine, CAM often lacks or has only limited experimental and clinical study; however, scientific investigation of CAM is beginning to address this knowledge gap. Thus, boundaries between CAM and mainstream medicine, as well as among different CAM systems, are often blurred and are constantly changing."
  • "...rather than a scientific (i.e. evidence-based) basis."
  • "The claims made by alternative medicine practitioners are generally not accepted by the medical community because evidence-based assessment of safety and efficacy is either not available or has not been performed for these practices. If scientific investigation establishes the safety and effectiveness of an alternative medical practice, it then becomes mainstream medicine and is no longer "alternative", and may therefore become widely adopted by conventional practitioners."
  • "Because alternative techniques tend to lack evidence, or may even have repeatedly failed to work in tests, some have advocated defining it as non-evidence based medicine, or not medicine at all."

The first and third bullets cover nearly the exact same topic, so I think it's redundant for us to keep both. makeswell (talk) 04:53, 17 August 2011 (UTC)

Agreed. And perhaps then we can begin to look at the large amounts of repetition in the main body of the article as well...? Vitaminman (talk) 08:23, 17 August 2011 (UTC)
I believe that it's hard to move forward until we either change the name of the article to Alternative and Complementary medicine, or at least state in the opening definition that the two are generally used today. IMO it has not been by accident that this has been hotly contested over the years since it allowed the article to use the most controversial forms of CAM to define it. For instance, for many years it was considered perfectly acceptable to use the definition offered by a non-medical person writing about folk medicine. What with almost all medical schools now including several different forms of CAM, it seems sort of silly to use definitions that say "all the crazy stuff that is unscientific and doesn't work", so as to speak. I just met up with an old friend the other day - she used to head radiology in a large hospital and she now is the head of complementary medicine in their cancer department (and she just finished a doctorate in CAM). There are plenty of instances of bias in "our" article. As just one, note that the article calls the Cochrane Collaboration definition as a "self definition", not even including it in the "scientific definition" section! Gandydancer (talk) 13:28, 18 August 2011 (UTC)
There used to be a specific Alternative and Complementary Medicine article on Wikipedia. You can read the discussions that lead up to the decision to merge and redirect here: [15] Personally, I have always disagreed with the notion that AM and CAM are one and the same thing and will continue to do so.Vitaminman (talk) 14:34, 18 August 2011 (UTC)
I'm not saying they are one and the same, nor is CAM. And it's not a "notion". Referencing and defining are very difficult with the article titled (only) alternative meds. Look at our refs and you can see that. What are your reasons for disagreement? Gandydancer (talk) 15:03, 18 August 2011 (UTC)
Whilst I would readily admit that the two terms are often (incorrectly) used synonymously, the correct usage is that complementary approaches are used together with orthodox medicine, while alternative medicine is used in place of orthodox medicine. There are very many reliable sources that support this, e.g. [16] Integrating two approaches that are very definitely not one and the same thing, just to make it easier to reference and define them, makes no sense. Vitaminman (talk) 15:50, 18 August 2011 (UTC)
While you may be technically correct, in practice the two tend to be combined. See our article "Usage" section for instance. There has seemed to be in this article some sort of fear that if we accept the fact that (for instance) we include information that shows that if complementary practices for cancer therapy are included without a dire suggestion that they are worthless, people will rush out and use snake oil to cure their newly diagnosed cancer. In fact, the number of people in the developed world that are substituting alternative therapies for modern medicine is extremely small. On the other hand, the number of people that are using "alternative therapies" to compliment their standard medical care (integrative/complementary medicine) continues to grow. If you insist on the narrow definition of alternative medicine, we would need to delete most of this article. Gandydancer (talk) 19:07, 18 August 2011 (UTC)

Conclusion

It's been 15 days, one person agreed with the changes, and zero people have voiced any qualms about the revision I proposed, so I'm going to go ahead and publish them. makeswell (talk) 21:44, 1 September 2011 (UTC) I personally felt that the lede was heavy on the scientific study and light on the actual practice of alternative medicine. It is our responsibility to be objective and maintain a neutral viewpoint. In concordance with this we should present what exists: the scientific opinions (about what exists or doesn't) in addition to the widespread practice of alternative medicine. I hope the revision reflects this NPOV attitude. makeswell (talk) 21:44, 1 September 2011 (UTC)

history

i would like to see a history section here. :)

75.149.68.209 (talk) 23:38, 31 August 2011 (UTC)

Me too! I'd like for you to write it. ;-) Jesanj (talk) 23:43, 31 August 2011 (UTC)
I guess a part of history could be taken from here, at least two-three sentences. 76.193.182.126 (talk) 21:09, 1 September 2011 (UTC)

"Criticism" Section

This section seems to criticise opponents of Alternative medicine, not alternative medicine itself...

"The NCCAM budget has been criticized[97] because despite the duration and intensity of studies about the efficacy of alternative medicine, there have been exactly zero effective CAM treatments supported by scientific evidence to date."

Sounds here like someone is real arrogant about alternative medicine, and their use of the words "exactly zero effective[...]" etc., make it sound a bit biased towards proponents of Alternative Medicine, not sceptics who are criticising it.

"Despite this, the National Center for Complementary and Alternative Medicine budget has been on a sharp sustained rise to support complementary medicine. In fact, the whole CAM field has been called by critics the SCAM.[98]"

Come on, how is this criticism? Sounds like..."support" to me, from what the author even wrote in there ("support complementary medicine").

As the author goes on:

"There really is no such thing as alternative medicine--only medicine that has been proved to work and medicine that has not." Dr. Arnold Relman, editor in chief emeritus of The New England Journal of Medicine"

Sounds like more support.

In fact, the only writing relevant to this section at all is the last two sentences:

"Speaking of government funding studies of integrating alternative medicine techniques into the mainstream, Dr. Steven Novella, a neurologist at Yale School of Medicine wrote that it "is used to lend an appearance of legitimacy to treatments that are not legitimate." Dr. Marcia Angell, executive editor of The New England Journal of Medicine says, "It's a new name for snake oil."[97]"


Am I missing something here, or does this section need a rewrite?... 174.62.155.87 (talk) 03:00, 1 September 2011 (UTC)

No, I don't think you're missing anything - I agree that the section could use some serious improvements, and could probably be expanded, too. I'll see what I can find in the way of reliable sources. Dawn Bard (talk) 03:35, 1 September 2011 (UTC)
Actually, the majority of the article seems to be a criticism of alternative medicine. In this sense, the criticism section is essentially superfluous as its content is effectively duplicated, to all intents and purposes, in the rest of the article. Oh yes, and the article is also way too long... Vitaminman (talk) 20:59, 1 September 2011 (UTC)

I think theres a form youall missed

Not comepletely sure, but isn't there a therapy called Zero Balance? I'm not sure if its classified as alternative medicine, but I'm looking for it. 74.138.183.168 (talk) 21:00, 5 October 2011 (UTC)

This article isn’t the place for a list of alternative therapies. If this is the “zero balance” you’re talking about, then it seems to be a type of energy medicine, and definitely alternative in nature. — TheHerbalGerbil(TALK|STALK), 13:50, 6 October 2011 (UTC)

Ontario medical college votes for tougher scrutiny for alternative medicine

Ontario medical college votes for tougher scrutiny for alternative medicine. Tom Blackwell, National Post Nov 29, 2011

Brangifer (talk) 08:39, 29 November 2011 (UTC)

Australian doctors protest teaching of alt med in universities

AUSTRALIA'S top doctors want university courses in acupuncture, chiropractic and naturopathy scrapped, claiming they are a misuse of public money and encourage quackery.
Thirty-four of Australia's top doctors, medical researchers and scientists have signed a petition challenging universities that "give undeserved credibility to 'alternative' therapies".
Signatories include Australian Medical Association president Dr Steve Hambleton and University of NSW Medicine Professor John Dwyer, who is also the founder of the Australian Health Care Reform Alliance.
IT appears the great debate regarding alternative medicine is far from over.
This week, 34 of Australia's most prominent doctors, medical researchers and scientists voiced their concern that the public are at risk of being misled about health treatments.
This outcry arose from the announcement that another Australian university announces plans to teach an "Alternative" medicine course as if it were science.
In August, Central Queensland University announced their decision to offer a chiropractor degree at their Mackay campus from 2012.

Brangifer (talk) 03:04, 12 December 2011 (UTC)

Appeal

I added an Ernst quote to the last chapter ('Appeal') in the main article, giving its title extra meaning and poignacy.Sleuth21 (talk) 13:48, 13 December 2011 (UTC)

This article is entirely biased

Talk page violation. Wikipedia is not a forum
The following discussion has been closed. Please do not modify it.

This article, along with similar articles, is entirely biased in favor of the anti-CAM point of view. Even if a notable figure such as Linus Pauling expresses support for large amounts of vitamin supplementation, for example, anything supposedly "discounting" it is brought up as "evidence". Obviously, this is the result of long, sustained effort by ideological vigilante groups. — Preceding unsigned comment added by 128.114.105.84 (talk) 10:22, 8 January 2012 (UTC)

You are correct. Intelligent people have a healthy skepticism of both CAM and mainstream medicine since they both have their share of crooks and liars. Studies show that the more well-educated a person is (in the U.S.), the more likely they are to use some form of CAM. No study has been done, but I'd guess that only a fool would take Wikipedia as an expert on this topic. Gandydancer (talk) 14:50, 8 January 2012 (UTC)
Wikipedia is an encyclopedia that reports the consensus of the mainstream experts in any given field, and as such is going to be biased towards that which is published in peer reviewed medical journals, and against CAM by definition of it not being mainstream. Indeed, the second that a CAM treatment is shown to be efficacious it ceases to be CAM and becomes simply "medicine." Many people think that wikipedia is "neutral" in the same way that a journalist seeks to be "balanced," but that is not what our WP:NPOV policy states. It's confusing wording for sure, but it's explained on the policy page.
@Gandydancer: that people educated in non-medical fields are more apt to engage CAM is wholly irrelevant as being highly educated in something like anthropology says nothing at all about your knowledge of medicine, nor your ability to think logically or critically. If you had said that education in medicine is correlated with an embrace of CAM then the statement would mean something but as it stands there is an inverse correlation between knowledge of medicine/biology and acceptance of CAM.
Gandydancer, you have to be a little bit more careful of how you phrase things. Your ‘No study has been done’ is an assertion one can’t easily disprove. Had you said ‘I haven’t found a study’ I could work on it and ‘’perhaps’’ enlightened you by showing you one (that’s ‘’showing’’ not ‘’shoving’’, mind).
… and 128.114.105.84: 'Obviously, this is the result of long, sustained effort by ideological vigilante groups'? Oh no it isn’t! Look at the very last quote in the body of the Alternative Medicine article: it contains the most (and I quote) ‘poignant criticism’ of mainstream medicine you can imagine, and it comes from an archetypal proponent of regular medicine. Only regular medicine is able to claim such level of self-criticism and reflection. Repent! :-) And your suggestion that Linus Pauling ‘expresses support’ is wrong on at least two counts 1) it should be ‘expressed support’ and 2) he told me at a reception we gave him after a lecture at Hamburg University in 1964 that he was 'slightly’ embarrassed by the support he got from the ‘wrong guys’ (as he phrased it). Today we would perhaps say ‘quarters’. sleuth21 Sleuth21 (talk) 02:13, 9 January 2012 (UTC)
Much of the prevailing attitude I see on wikipedia seems to be a combination of appeal to authority and appeal to popularity. There is the presumption that mianstream consensus is "correct" when, in reality, we often find that what we are dealing with is simply more powerful people pushing their agenda, who are able to do so more successfully than marginalized voices. Marcia Angell was formerly the editor in chief of the New England Journal of Medicine. In an article entitled "Big Pharma, Bad Medicine How corporate dollars corrupt research and education", she detailed some of these problems: http://bostonreview.net/BR35.3/angell.php
As noted before, even the Journal of the American Medical Association noted that modern medicine is the third leading cause of death in the United States. This is not accidental. Often, purported medical "miracles" are pushed, while the pushers are fully cognizant of their toxic effects. See, for example, the example of Fluoride. The JAMA noted, just before U.S. drinking water became fluoridated: "Fluorides are general protoplasmic poisons, probably because of their capacity to modify the metabolism of cells by changing the permeability of the cell membrane and by inhibiting certain enzyme systems ... The sources of fluorine intoxication are drinking water containing 1 ppm or more of fluorine, fluorine compounds used as insecticidal sprays for fruits and vegetables (cryolite and barium fluosilicate) and the mining and conversion of phosphate rock to superphosphate, which is used as fertilizer. The fluorine content of phosphate rock, about 25% of the fluorine present, is volatilized and represents a pouring into the atmosphere of approximately 25,000 tons of pure fluorine annually ... The known effects of chronic fluorine intoxication are those of hypophasia of the teeth, which has been called mottled enamel, and of bone sclerosis." - Journal of the American Medical Association, editorial, September 18, 1943 (123:50): http://jama.ama-assn.org/content/123/3/150.2.short
The following clip is an experiment exposing cells to Fluoride during the time period. It also shows that government knew about the dangers of fluoride during that time period: http://www.brasschecktv.com/videos/water/fluoride-theyve-known-the-dangers-all-along-.html
For information on how this poison was marketed and the ADA bought up, see The Fluoride Deception, which has been praised by Nobel Laureates like Dr. Arvid Carlsson.
Also, onto vaccination. Dr. Maurice Hilleman, who worked at Merck on the polio vaccine, admitted that it was deliberately contaminated with cancer causing SV-40: http://www.youtube.com/watch?v=13QiSV_lrDQ
If you are skeptical, I can provide you with around 100 peer-reviewed citations showing lethal effects from vaccinations. But I don't want to use that much space at present. So I recommend, as an introduction, the documentary "Lethal Injection: The Story of Vaccination": http://www.youtube.com/watch?v=7hITYIT02rA
Lily Kay, in a recent book called "The Molecular Foundation of Life", published by Oxford University press (http://www.oup.com/us/catalog/general/subject/LifeSciences/MolecularCellBiology/?view=usa&ci=9780195111439), described the influence of the Rockefeller Foundation and it's eugenic outlook in much of this research. The book can be read online: http://books.google.co.uk/books?id=mHTuL_bRLBQC&dq=The+molecular+vision+of+life&printsec=frontcover&source=bn&hl=en&ei=h-tZTJGdIZP40wSUtt3ZCA&sa=X&oi=book_result&ct=result&resnum=4&ved=0CCcQ6AEwAw#v=onepage&q&f=false
We often find this in other fields as well. Indiana University professor of education, Robert F. Arnove, noted in his text Philanthropy and Cultural Imperialism:
"The power of the foundation is not that of dictating what will be studied. Its power consists in defining professional and intellectual parameters, in determining who will receive support to study what subjects in what settings. And the foundation’s power resides in suggesting certain types of activities it favors and is willing to support. As [influential political theorist and economist Harold] Laski noted, “the foundations do not control, simply because, in the direct and simple sense of the word, there is no need for them to do so. They have only to indicate the immediate direction of their minds for the whole university world to discover that it always meant to gravitate to that angle of the intellectual compass.”" (Robert F. Arnove, ed., Philanthropy and Cultural Imperialism: The Foundations at Home and Abroad (Indiana University Press: Boston, 1980), p. 319)
In the 1946 Annual Report of the Rockefeller Foundation, we find, on p. 188, the following (in opposition to the efforts of revisionists like Harry Elmer Barnes, Charles Callan Tansill, etc.): http://www.rockefellerfoundation.org/uploads/files/81f6aa9b-5d37-4a64-a65c-6327e71077c6-1946.pdf
"The Committee on Studies of the Council on Foreign Relations is concerned that the debunking journalistic campaign following World War I should not be repeated and believes that the American public deserves a clear competent statement of our basic aims and activities during the second World War."
In other words, omission of inconvenient facts.
This pattern can be shown in many other fields as well.
Commenting on this trend, the sociologist Jacques Ellul noted in his book "Propaganda", "Naturally, the educated man does not believe in propaganda, he shrugs and is convinced that propaganda has no effect on him. This is, in fact, one of his great weaknesses, and propagandists are well aware that in order to reach someone, one must first convince him that propaganda is ineffectual and not very clever. Because he is convinced of his own superiority, the intellectual is much more vulnerable than anybody else to this maneuver."
And on p. 81, he noted:
"The individual's adherence to his group is "conscious" because he is aware of it and recognizes it, but it is ultimately involuntary because he is trapped in a dialectic and in a group that leads him unfailingly to his adherence. His adherence is also 'intellectual' because he can express his conviction clearly and logically, but it is not genuine because the information, the data, the reasoning, that have led him to adherence to the group were themselves deliberately falsified in order to lead him there." — Preceding unsigned comment added by Pottinger's cats (talk • contribs) 04:52, 9 January 2012 (UTC)
(i) WP:TLDR (ii) Yes, it's very much appeal to authority. We are an encyclopedia that represents the mainstream and our policies are specifically geared to this effect. Noformation Talk 04:59, 9 January 2012 (UTC)
And that's why it's unreliable because, as demonstrated here, that "authority" is entirely malicious. Here are the studies on vaccines:

Bichel, "Post-vaccinial Lymphadenitis Developing into Hodgkin's Disease", Acta Med Scand, 1976, Vol 199, p523-525.

Stewart, AM, et al, "Aetiology of Childhood Leukaemia", Lancet, 16 Oct, 1965, 2:789-790. [Listed under Vaccine Adverse Reactions.]

Glathe, H et al, "Evidence of Tumorigenic Activity of Candidate Cell Substrate in Vaccine Production by the Use of Anti-Lymphocyte Serum", Development Biol Std, 1977, 34:145-148.

Bolognesi, DP, "Potential Leukemia Virus Subunit Vaccines: Discussion", Can Research, Feb 1976, 36(2 pt 2):655-656.

Colon, VF, et al, "Vaccinia Necrosum as a Clue to Lymphatic Lymphoma", Geriatrics, Dec 1968, 23:81-82.

Park-Dincsoy, H et al, "Lymphoid Depletion in a case of Vaccinia Gangrenosa", Laval Med, Jan 1968, 39:24-26.

Hugoson, G et al, "The Occurrence of Bovine Leukosis Following the Introduction of Babesiosis Vaccination", Bibl Haemat, 1968, 30:157-161.

Hartstock, , ""Post-vaccinial Lymphadenitis: Hyperplasia of Lymphoid Tissue That Simulates Malignant Lymphomas", Apr 1968, Cancer, 21(4):632-649.

Allerberger, F, "An Outbreak of Suppurative Lymphadenitis Connected with BCG Vaccination in Austria- 1990/1991," Am Rev Respir Disorder, Aug 1991, 144(2) 469.

Omokoku B, Castells S, "Post-DPT inoculation cervical lymphadenitis in children." N Y State J Med 1981 Oct;81(11):1667-1668.

Vaccines and Chromosome Changes Leading to Mutations: Knuutila, S et al, "An Increased Frequency of Chromosomal Changes and SCE's in Cultured Lymphocytes of 12 Subjects Vaccinated Against Smallpox," Hum Genet, 1978 Feb 23; 41(1):89-96.

Cherkeziia, SE, et al, "Disorders in the Murine Chromosome Apparatus Induced By Immunization with a Complex of Anti-viral Vaccines," Vopr Virusol, 1979 Sept Oct, (5):547-550.

[Note: SCE means sister chromatid exchange and is an indication that genetic mutations are occurring, which could possibly lead to cancer-causing mutations.]

Vaccines and Auto-immunity Citations: Romanov, V A, et al, "Role of Auto-immune Processes in the Pathogenesis of Post-Vaccinal Lesions of the Nervous System", Oct 1977, Zh Mikrobiol Epidemiol Immunobiol, 10:80-83.

Grachev, V P, et al, "Formation of Auto-antibodies in Laboratory Animals After Inoculation of Viruses With Different Virulence. I. Results of Studies ..., July 1973, Acta Virol (Praha), 17:319-326.

Movsesiants, AA, et al, "Experimental Study of the Ability of Different Strains of Vaccinia Virus to Induce Auto-Antibody Formation", Vopr Virusol, May-Jun 1975; (3):297-302.

Negina, IuP, "Comparative Study of Auto-antibody Formation Following Immunization With Different Types of Typhoid Vaccines", Zh Mikrobiol Epidemiol Immunobiol, May 1980; (5):69-72.

Vaccinations and Diabetes Citations: Sinaniotis, et al, "Diabetes Mellitus after Mumps Vaccination", Arc Dis Child, 1975, 50:749.66

Polster, H, "Diabetes insipidus after Smallpox vaccination", Z Aerztl Fortbild (Jena), 1 Apr 1966, 60:429-432.

Patan, "Postvaccinal Severe Diabetes Mellitus", Ter Arkh, Jul 1968, 40:117-118.

Classen, JB, MD, "The Timing of Immunization Affects The Development of Diabetes in Rodents", Autoimmunity, 1996, 24:137-145.

Classen JB, "The diabetes epidemic and the hepatitis B vaccines," N Z Med J, 109(1030):366 1996 Sep 27. [letter]

Classen JB, "Childhood immunisation and diabetes mellitus," N Z Med J, 109(1022):195 1996 May 24 [letter]

Poutasi K, " Immunisation and diabetes," N Z Med J 1996 Jul 26;109(1026):283. [letter; comment]

Other Articles Linking Diabetes to Vaccines: Dokheel, T M, "An Epidemic of Childhood Diabetes in the United States? Evidence from ....", Diabetes Care, 1993, 16:1606-1611.

Parent ME, et al, "Bacille Calmette-Guerin vaccination and incidence of IDDM in Montreal, Canada," Diabetes Care 1997 May; 20(5):767-772.

House DV, Winter WE, "Autoimmune diabetes. The role of auto-antibody markers in the prediction and prevention of insulin-dependent diabetes mellitus," Clin Lab Med 1997 Sep; 17(3):499-545.

Zeigler, M et al , "[Autoantibodies in type 1 diabetes mellitus]" Z Arztl Fortbild (Jena). 1994 Aug; 88(7-8:561-5

Vaccines and Nervous System Changes: Bondarev, VN et al, "The Changes of the Nervous System in Children After Vaccination", Pediatria, Jun 1969; 48:20-24.

Ehrengut W, "Central nervous sequelae of vaccinations," Lancet 1986 May 31;1(8492):1275-1276.

Provvidenza, G et al, [On a Case of Benign Acute Cerebellar Ataxia in Childhood], Arch Ital Sci Med Trop, 43:189-194, Apr 1962.

Katsilambros, L, "[The Phenomenom of Apathy in Man and Animals After the Injection of Viruses in Very High Doses. Clinical Data]", Rev Med Moyen Orient, 20:539-546, Nov - Dec 1963.

Vaccinations and Autism Citations: Eggers, C, "Autistic Syndrome (Kanner) And Vaccinations against Smallpox", Klin Paediatr, Mar 1976, 188(2):172-180.

Kiln MR, "Autism, inflammatory bowel disease, and MMR vaccine." Lancet 1998 May 2;351(9112):1358.

Selway, "MMR vaccination and autism 1998. Medical practitioners need to give more than reassurance." BMJ 1998 Jun 13;316(7147):1824.

Nicoll A, Elliman D, Ross E, "MMR vaccination and autism 1998," MJ 1998 Mar 7;316(7133):715-716.

Lindley K J, Milla PJ, "Autism, inflammatory bowel disease, and MMR vaccine."Lancet 1998 Mar 21;351(9106):907-908.

Bedford H, et al, "Autism, inflammatory bowel disease, and MMR vaccine." Lancet 1998 Mar 21;351(9106):907.

Vijendra K. Singh, Sheren X. Lin, and Victor C. Yang, "Serological Association of Measles Virus and Human Herpesvirus-6 with Brain Autoantibodies in Autism," Clinical Immunology and Immunopathology, Oct 1998, Vol. 89, No. 1, p 105-108. ["None of the autistic children in the study had measles in the past, but all had the MMR" stated David Whalgren.]

Vaccines and Demyelination Citations: Herroelen, L et al, "Central-Nervous-System Demyelination After Immunization with Recombinant Hepatitis B Vaccine", Lancet, Nov 9, 1991, 338(8776):1174-1175.

Kaplanski G, Retornaz F, Durand J, Soubeyrand J, "Central nervous system demyelination after vaccination against hepatitis B and HLA haplotype." J Neurol Neurosurg Psychiatry 1995 Jun; 58(6):758-759.

Matyszak MK, Perry VH, "Demyelination in the central nervous system following a delayed-type hypersensitivity response to bacillus Calmette-Guerin." Neuroscience 1995 Feb;64(4):967-977.

Tornatore CS, Richert JR, "CNS demyelination associated with diploid cell rabies vaccine." Lancet 1990 Jun 2;335(8701):1346-1347.

Adams, JM et al, "Neuromyelitis Optica: Severe Demyelination Occurring Years After Primary Smallpox Vaccinations", Rev Roum Neurol, 1973, 10:227-231.

In 1988, Dietrich used MRI to show that developmentally delayed children had alterations in their myelin. Coulter described that central nervous system damage can be exhibited as abnormal behavior of the child. In 1935, Thomas Rivers, experimental allergic encephalitis (EAE) can be the result of a viral or bacterial infection of the nervous system. "The fact of the matter is that it is a matter of record that it was known that vaccination produced encephalitis since 1926." The authors stated, "In regions in which there is no organized vaccination of the population, general paralysis is rare. ... It is impossible to deny a connection between vaccinations and the encephalitis (brain damage) which follows it."

Vaccines have been linked to seizures, convulsions and epilepsy. Vaccinations and Seizures: Hirtz DG, Nelson KB, Ellenberg J H, "Seizures following childhood immunizations", Pediatr 1983 Jan; 102(1):14-18.

Cherry JD, Holtzman AE, Shields WD, Buch D, Nielsen, "Pertussis immunization and characteristics related to first seizures in infants and children,"J Pediatr 1993 Jun;122(6):900-903.

Coplan J, "Seizures following immunizations," J Pediatr 1983 Sep;103(3):496.

Barkin RM, Jabhour JT, Samuelson J S, "Immunizations, seizures, and subsequent evaluation," JAMA 1987 Jul 10;258(2):201.

Griffin MR, et al, "Risk of seizures after measles-mumps-rubella immunization," Pediatrics 1991 Nov;88(5):881-885.

Griffin MR, et al, "Risk of seizures and encephalopathy after immunization with the diphtheria-tetanus-pertussis vaccine," JAMA 1990 Mar 23-30;263(12):1641-1645.

Cizewska S, Huber Z, Sluzewski W, "[Prophylactic inoculations and seizure activity in the EEG]," Neurol Neurochir Pol 1981 Sep-Dec;15(5-6):553-557. [Article in Polish]

Huttenlocher PR, Hapke RJ, "A follow-up study of intractable seizures in childhood." Ann Neurol 1990 Nov; 28(5):699-705.

Blumberg DA, "Severe reactions associated with diphtheria-tetanus-pertussis vaccine: detailed study of children with seizures, hypotonic-hypo-responsive episodes, high fevers, and persistent crying."Pediatrics 1993 Jun; 91(6):1158-1165.

Vaccinations and Convulsions Citations: Prensky AL, et al, "History of convulsions and use of pertussis vaccine," J Pediatr 1985 Aug; 107(2):244-255.

Baraff LJ, "Infants and children with convulsions and hypotonic-hypo-responsive episodes following diphtheria-tetanus-pertussis immunization: follow-up evaluation," Pediatrics 1988 Jun; 81(6):789-794.

Jacobson V, "Relationship of pertussis immunization to the onset of epilepsy, febrile convulsions and central nervous system infections: a retrospective epidemiologic study," Tokai J Exp Clin Med 1988;13 Suppl: 137-142.

Cupic V,et al, "[Role of DTP vaccine in the convulsive syndromes in children]," Lijec Vjesn 1978 Jun; 100(6):345-348. [Article in Serbo-Croatian (Roman)]

Pokrovskaia NIa, "[Convulsive syndrome in DPT vaccination (a clinico-experimental study)]," Pediatriia 1983 May;(5):37-39. [Article in Russian]

Vaccinations and Epilepsy Citations: Ballerini, Ricci, B, et al, "On Neurological Complications of Vaccination, With Special Reference to Epileptic Syndromes," Riv Neurol, Jul-Aug 1973, 43:254-258.

Wolf SM, Forsythe A, "Epilepsy and mental retardation following febrile seizures in childhood," Acta Paediatr Scand 1989 Mar;78(2):291-295.

Vaccines and Brain Swelling: Iwasa, S et al, "Swelling of the Brain in Mice Caused by Pertussis ... Quantitative Determination and the Responsibility of the Vaccine", Jpn J Med Sci Biol, 1985 , 38(2):53-65.

Mathur R, Kumari S, "Bulging fontanel following triple vaccine." Indian Pediatr 1981 Jun;18(6):417-418.

Barry W, Lenney W, Hatcher G, "Bulging fontanelles in infants without meningitis." Arch Dis Child 1989 Apr;64(4):635-636.

Shendurnikar N, "Bulging fontanel following DPT" Indian Pediatr 1986 Nov;23(11):960.

Gross TP, Milstien JB, Kuritsky JN, "Bulging fontanelle after immunization with diphtheria-tetanus-pertussis vaccine and diphtheria-tetanus vaccine." J Pediatr 1989 Mar;114(3):423-425.

Jacob J, Mannino F, "Increased intracranial pressure after diphtheria, tetanus, and pertussis immunization." Am J Dis Child 1979 Feb;133(2):217-218.

Dugmore, WN, "Bilateral Oedema at the Posterior Pole. Hypersensitivity Reaction to Alavac P injection." Br J Ophthalmol, Dec 1972, 55:848-849.

Vaccines and Neurological Damage: Nedar P R, and Warren, R J, "Reported Neurological Disorders Following Live Measles Vaccine", 1968, Ped, 41:997-1001.

Paradiso, G et al, "Multifocal Demyelinating Neuropathy after Tetanus Vaccine", Medicina (B Aires), 1990, 50(1):52-54.

Landrigan, PJ, Whitte, J, "Neurologic Disorders Following Live Measles-virus Vaccination", JAMA, Mar 26, 1973, v223(13):1459-1462.

Turnbull, H M, "Encephalomyelitis Following Vaccination", Brit Jour Exper Path, 7:181, 1926.

Kulenkampff, M et al, "Neurological Complications of Pertussis Inoculation", Arch Dis Child, 1974, 49:46.

Strom, J, "Further Experience of Reactions, Especially of a Cerebral Nature in Conjunction with Triple Vaccination", Brit Med Jour, 1967, 4:320-323.

Berg, J M, "Neurological Complications of Pertussis Immunization," Brit Med Jour, July 5,1958; p 24.

Bondarev, VN et al, "The Changes of the Nervous System in Children After Vaccination", Pediatria, Jun 1969; 48:20-24.

Badalian, LO, "Vaccinal Lesions of the Nervous System in Children," Vop Okhr Materin Dets, Dec 1959, 13:54-59

Lorentz, IT, et al, "Post-Vaccinal Sensory Polyneuropathy with Myoclonus", Proc Aust Ass Neurol, 1969, 6:81-86.

Trump, R C, White, T R, "Cerebellar Ataxia Presumed Due To Live Attenuated Measles Virus Vaccine," JAMA, 1967, 199:165-166.

Allerdist, H, "Neurological Complications Following Measles Vaccination", Inter Symp, Brussels, 1978, Development Biol Std, Vol 43, 259-264.

Finley, K H, "Pathogenesis of Encephalitis Occurring With Vaccination, Variola and Measles, Arch Neur and Psychologist, 1938; 39:1047-1054.

Froissart, M et al, "Acute Meningoencephalitis Immediately after an Influenza Vaccination", Lille Med, Oct 1978, 23(:548-551.

Pokrovskaia, Nia, et al, "Neurological Complications in Children From Smallpox Vaccination", Pediatriia, Dec 1978, (12):45-49.

Allerdist, H, "Neurological Complications Following Measles Virus Vaccination. Evaluation of the Cases seen Between 1971-1977″, Monatsschr Kinderheilkd, Jan 1979, 127(1): 23-28.

Ehrengut, W et al, "On Convulsive Reactions Following Oral vaccination Against Polio", Klin Paediatr, May 1979, 191(3):261-270.

Naumova, R P, et al, "Encephalitis Developing After Vaccination without a Local Skin Reaction", Vrach Delo, Jul 1979, (7):114-115.

Goswamy, BM, "Neurological Complications After Smallpox Vaccination", J Ass Phys India, Jan 1969, 17:41-43.

Schchelkunov, SN et al, "The Role of Viruses in the Induction of Allergic Encephalomyelitis," Dokl Akad Nauk SSSR, 1990,315(1):252-255. [Vaccines contain viruses, too]

Walker AM, "Neurologic events following diphtheria-tetanus-pertussis immunization," Pediatrics 1988 Mar;81(3):345-349.

Shields WD, et al, "Relationship of pertussis immunization to the onset of neurologic disorders: a retrospective epidemiologic study," J Pediatr 1988 Nov; 113(5):801-805.

Wilson J, "Proceedings: Neurological complications of DPT inoculation in infancy," Arch Dis Child 1973 Oct; 48(10):829-830.

Iakunin IuA, "[Nervous system complications in children after preventive vaccinations]," Pediatriia 1968 Nov; 47(11):19-26. [Article in Russian]

Greco D, et al, "Case-control study on encephalopathy associated with diphtheria-tetanus immunization in Campania, Italy," Bull World Health Organ 1985;63(5):919-925.

Ehrengut W at Institute of Vaccinology and Virology, Hamburg, Germany states, "Bias in the evaluation of CNS complications following pertussis immunization are the following: 1) Notifications of post-immunization adverse events, 2) Publications by vaccine producers on the frequency of adverse reactions, 3) Comparison of permanent brain damage after DPT and DT immunization, 4) Pro-immunization, 5) Immunization associated viral encephalitis, 6) Accuracy of statistics, 7) Personal. A review of these points indicates an underestimation of CNS complications after pertussis immunization."

Reference: Ehrengut W, "Bias in evaluating CNS complications following pertussis immunization." Acta Paediatr Jpn, 1991 Aug; 33(4):421-427.

Vaccinations and Unexplained Diseases: Hiner, E E, Frasch, C E, "Spectrum of Disease Due to Haemophilus Influenza Type B Occurring in Vaccinated Children", J Infect Disorder, 1988 Aug; 158(2): 343-348.

Olin P, Romanus, V, Storsaeter, J, "Invasive Bacterial Infections During an Efficiacy Trial of Acellular Pertussis Vaccines - Implications For Future Surveilance In Pertussis Vaccine Programmes", Tokai J Exp Clin Med, 1988; 13 Suppl: 143-144.

Storsaeter, J, et al, "Mortality and Morbidity From Invasive Bacterial Infections During a Clinical Trial of Acellular Pertussis Vaccines in Sweden", Pediatr Infect Disorder J, 1988 Sept; 7(9):637-645.

Vadheim, CM, et al, "Effectiveness and Safety of an Haemophilus Influenzae type b Conjugate Vaccine (PRP-T) in Young Infants. Kaiser-UCLA Vaccine Study Group," Pediartics, 1993 Aug; 92(2):272-279. [The vaccines caused fevers, irritability, crying, and seizures, but were declared to be "safe and ... effective ... ".]

Stickl, H, "Estimation of Vaccination Damage", Med Welt, Oct 14, 1972, 23:1495-1497.

Waters, VV, et al, "Risk Factors for Measles in a Vaccinated Population", JAMA, Mar 27, 1991, 265(12): 1527.

Stickl, H, "Iatrogenic Immuno-suppression as a Result of Vaccination", Fortschr Med, Mar 5, 1981, 99(9);289-292.

Vaccine Citations Linking the Vaccine to the "prevented" Disease: Nkowane, et al, "Vaccine-Associated Paralytic Poliomyelitis, US 1973 through 1984, JAMA, 1987, Vol 257:1335-1340.

Quast, et al, "Vaccine Induced Mumps-like Diseases", nd, Int Symp on Immun, Development Bio Stand, Vol 43, p269-272.

Green, C et al, "A Case of Hepatitis Related to Etretinate Therapy and Hepatitis B Vaccine", Dermatologica, 1991, 182(2):119-120. Shasby, DM, et al, "Epidemic Measles in Highly Vaccinated Population", NEJM, Mar 1977, 296(11): 585-589.

Tesovic, G et al, "Aseptic Meningitis after Measles, Mumps and Rubella Vaccine", Lancet, Jun 12, 1993, 341(8859):1541.

Johnson, RH, et al, "Nosocomial Vaccinia Infection", West J Med, Oct 1976, 125(4):266-270.

Malengreau, M, "Reappearance of Post-Vaccination Infection of Measles, Rubella, and Mumps. Should Adolescents be re-vaccinated?" Pedaitric, 1992;47(9):597-601 (25 ref)

Basa, SN, "Paralytic Poliomyelitis Following Inoculation With Combined DTP Prophylactic. A review of Sixteen cases with Special Reference to Immunization Schedules in Infancy", J Indian Med Assoc, Feb 1, 1973, 60:97-99.

Landrigan, PJ et al, "Measles in Previously Vaccinated Children in Illinois", Ill Med J, Arp 1974, 141:367-372. 11111 NA, "Vaccine-Associated Poliomyelitis", Med J Aust, Oct 1973, 2:795-796.

Vaccine Failures Citations: Hardy, GE, Jr, et al, "The Failure of a School Immunization Campaign to Terminate an Urban Epidemic of Measles," Amer J Epidem, Mar 1970; 91:286-293.

Cherry, JD, et al, "A Clinical and Serologic Study of 103 Children With Measles Vaccine Failure", J Pediatr, May 1973; 82:801-808.

Jilg, W, et al, "Inoculation Failure Following Hepatitis B Vaccination", Dtsch Med wochenschr, 1990 Oct 12; 115(41):1514-1548.

Plotkin, SA, "Failures of Protection by Measles Vaccine," J Pediatr, May 1973; 82:798-801.

Bolotovskii, V, et al, "Measles Incidence Among Children Properly Vaccinated Against This Infection", ZH Mikrobiol Epidemiol Immunobiol, 1974; 00(5):32-35.

Landrigan, PJ, et al, "Measles in Previously Vaccinated Children in Illinois", Ill Med J, Apr 1974; 141:367-372.

Strebel, P et al, "An Outbreak of Whooping Cough in a Highly Vaccinated Urban Community", J Trop Pediatr, Mar 1991, 37(2): 71-76.

Forrest, JM, et al, "Failure of Rubella Vaccination to Prevent Congenital Rubella,"Med J Aust, 1977 Jan 15; 1(3): 77.

Jilg, W, "Unsuccessful Vaccination against Hepatitis B", Dtsch Med Wochenschr, Nov 16, 1990, 115(46):1773.

Coles, FB, et al, "An Outbreak of Influenza A (H3N2) in a Well-Immunized Nursing home Population," J Am ger Sociologist, Jun 1992, 40(6):589-592.

Jilg, W, et al, "Inoculation Failure following Hepatitis B Vaccination," Dtsch Med Wochenschr, Oct 12, 1990, 115(41):1545-1548.

Hartmann, G et al, "Unsuccessful Inoculation against Hepatitis B," Dtsch Med Wochenschr, May 17, 1991, 116(20): 797.

Buddle, BM et al, "Contagious Ecthyma Virus-Vaccination Failures", Am J Vet Research, Feb 1984, 45(2):263-266.

Mathias, R G, "Whooping Cough In Spite of Immunization", Can J Pub Health, 1978 Mar/Apr; 69(2):130-132.

Osterholm, MT, et al, "Lack of Efficacy of Haemophilus b Polysacharide Vaccine in Minnesota", JAMA, 1988 Sept 9; 260(10:1423-1428.

Johnson, RH, et al, "Nosocomial Vaccinia Infection", West J Med, Oct 1976, 125(4):266-270.

Vaccines Causing Another Vaccinal Disease: Basa, SN, "Paralytic Poliomyelitis Following Inoculation With Combined DTP Prophylactic. A review of Sixteen cases with Special Reference to Immunization Schedules in Infancy", J Indian Med Assoc, Feb 1, 1973, 60:97-99.

Pathel, JC, et al, "Tetanus Following Vaccination Against Small-pox", J Pediatr, Jul 1960; 27:251-263.

Favez, G, "Tuberculous Superinfection Following a Smallpox Re-Vaccination", Praxis, July 21, 1960; 49:698-699.

Quast, Ute, and Hennessen, "Vaccine-Induced Mumps-like Diseases", Intern Symp on Immunizations , Development Bio Stand, Vol 43, p 269-272.

Forrest, J M, et al, "Clinical Rubella Eleven months after Vaccination," Lancet, Aug 26, 1972, 2:399-400.

Dittman, S, "Atypical Measles after Vaccination", Beitr Hyg Epidemiol, 19891, 25:1-274 (939 ref)

Sen S, et al, "Poliomyelitis in Vaccinated Children", Indian Pediatr, May 1989, 26(5): 423-429.

Arya, SC, "Putative Failure of Recombinant DNA Hepatitis B Vaccines", Vaccine, Apr 1989, 7(2): 164-165.

Lawrence, R et al, "The Risk of Zoster after Varicella Vaccination in Children with Leukemia", NEJM, Mar 3, 1988, 318(9): 543-548.

Vaccination Citations and Death Na, "DPT Vaccination and Sudden Infant Death - Tennessee, US Dept HEW, MMWR Report, Mar 23, 1979, vol 28(11): 132.

Arevalo, "Vaccinia Necrosum. Report on a Fatal Case", Bol Ofoc Sanit Panamer, Aug 1967, 63:106-110.

Connolly, J H, Dick, G W, Field, CM, "A Case of Fatal Progressive Vaccinia", Brit Med Jour, 12 May 1962; 5288:1315-1317.

Aragona, F, "Fatal Acute Adrenal Insufficiency Caused by Bilateral Apoplexy of the Adrenal Glands (WFS) following Anti-poliomyelitis Vaccination", Minerva Medicolegale, Aug 1960; 80:167-173.

Moblus, G et al, "Pathological-Anatomical Findings in Cases of Death Following Poliomyelitis and DPT Vaccination", Dtsch Gesundheitsw, Jul 20, 1972, 27:1382-1386.

NA, "Immunizations and Cot Deaths", Lancet, Sept 25, 1982, np.

Goetzeler, A, "Fatal Encephalitis after Poliomyelitis Vaccination", 22 Jun 1961, Muenchen Med Wschr, 102:1419-1422.

Fulginiti, V, "Sudden Infant Death Syndrome, Diphtheria-Tetanus Toxoid-Pertussis Vaccination and Visits to the Doctor: Chance Association or Cause and Effect?", Pediatr Infect Disorder, Jan-Feb 1983, 2(1): 7-11.

Baraff, LJ, et al, "Possible Temporal Association Between Diphtheria-tetanus toxoid-Pertussis Vaccination and Sudden Infant Death Syndrome", Pediatr Infect Disorder, Jan-Feb 1983, 2(1): 5-6.

Reynolds, E, "Fatal Outcome of a Case of Eczema Vaccinatum", Lancet, 24 Sept 1960, 2:684-686.

Apostolov. et al, "Death of an Infant in Hyperthermia After Vaccination", J Clin Path, Mar 1961, 14:196-197.

Bouvier-Colle, MH, "Sex-Specific Differences in Mortality After High-Titre Measles Vaccination", Rev Epidemiol Sante Publique, 1995; 43(1): 97.

Stewart GT, "Deaths of infants after triple vaccine.", Lancet 1979 Aug 18;2(8138):354-355.

Flahault A, "Sudden infant death syndrome and diphtheria/tetanus toxoid/pertussis/poliomyelitis immunisation.", Lancet 1988 Mar 12;1(8585):582-583.

Larbre, F et al, "Fatal Acute Myocarditis After Smallpox Vaccination", Pediatrie, Apr-May 1966, 21:345-350.

Mortimer EA Jr, "DTP and SIDS: when data differ", Am J Public Health 1987 Aug; 77(:925-926. Vaccines and Metabolism Citations:

Deutsch J, " [Temperature changes after triple-immunization in infant age]," Padiatr Grenzgeb 1976;15(1):3-6. [Article in German]

NA, "[Temperature changes after triple immunization in childhood]," Padiatr Grenzgeb 1976;15(1):7-10. [Article in German]

[Considering that the thyroid controls our Basal Metabolism, it would appear that vaccines altered thyroid activity.]

Vaccines Altering Resistance to Disease: Burmistrova AL, "[Change in the non-specific resistance of the body to influenza and acute respiratory diseases following immunization diphtheria-tetanus vaccine]," Zh Mikrobiol Epidemiol Immunobiol 1976; (3):89-91. [Article in Russian]

Vaccinations and Deafness Citations: Kaga, "Unilateral Total Loss of Auditory and Vestibular Function as a Complication of Mumps Vaccination", Int J Ped Oto, Feb 1998, 43(1):73-73

Nabe-Nielsen, Walter, "Unilateral Total Deafness as a Complication of the Measles- Mumps- Rubella Vaccination", Scan Audio Suppl, 1988, 30:69-70

Hulbert, et al, "Bilateral Hearing Loss after Measles and Rubella Vaccination in an Adult", NEJM, 1991 July, 11;325(2):134

Healy, "Mumps Vaccine and Nerve Deafness", Am J Disorder Child, 1972 Jun; 123(6):612

Jayarajan, Sedler, "Hearing Loss Following Measles Vaccination", J Infect, 1995 Mar; 30(2):184-185

Pialoux, P et al, "Vaccinations and Deafness", Ann Otolaryng (Paris), Dec 1963, 80:1012-1013.

Angerstein, W, et al, "Solitary Hearing and Equilibrium Damage After Vaccinations", Gesundheitswesen, May 1995, 57(5): 264-268.

Brodsky, Stanievich, "Sensorineural Hearing Loss Following Live Measles Virus Vaccination", Int J Ped Oto, 1985 Nov; 10(2):159-163

Koga, et al, "Bilateral Acute Profound Deafness After MMR Vaccination- Report of a Case", Nippon Jibiin Gakkai Kai, 1991 Aug;94(:1142-5

Seiferth, LB, "Deafness after Oral Poliomyelitis Vaccination - a Case Report and Review", HNO, 1977 Aug; 25(: 297-300

Pantazopoulos, PE, "Perceptive Deafness Following Prophylactic use of Tetanus anittoxin", Laryngoscope, Dec 1965, 75:1832-1836.

Zimmerman, W, "Observation of a case of Acute Bilateral Hearing Impairment Following Preventive Poliomyelitis Vaccination (type 3)", Arch Ohr Nas Kehlkopfheilk, 1965, 185:723-725.

Vaccinations and Kidney Disorders Citations: Jacquot, C et al, "Renal Risk in Vaccination", Nouv Presse Med, Nov 6, 1982, 11(44):3237-3238.

Giudicelli, et al, "Renal Risk in Vaccination", Presse Med, Jun 11, 1982, 12(25):1587-1590.

Tan, SY, et al, "Vaccine Related Glomerulonephritis", BMJ, Jan 23, 1993, 306(6872):248.

Pillai, JJ, et al, "Renal Involvement in Association with Post-vaccination Varicella", Clin Infect Disorder, Dec 1993, 17(6): 1079-1080.

Eisinger, AJ et al, "Acute Renal Failure after TAB and Cholera Vaccination", B Med J, Feb 10, 1979, 1(6160):381-382.

Silina, ZM, et al, "Causes of Postvaccinal Complications in the Kidneys in Young Infants", Pediatria, Dec 1978, (12):59-61.

Na, "Albuminurias", Concours Med, Mar 1964, 85:5095-5098. [vaccination adverse reactions]

Oyrl, A, et al, "Can Vaccinations Harm the Kidney?", Clin Nephrol, 1975, 3(5):204-205.

Mel'man Nia, "[Renal lesions after use of vaccines and sera]." Vrach Delo 1978 Oct;(10):67-9, [Article in Russian]

Silina ZM, Galaktionova TIa, Shabunina NR, "[Causes of postvaccinal complications in the kidneys in young infants]." Pediatriia 1978 Dec;(12):59-61, [Article in Russian]

Silina EM, et al, "[Some diseases of the kidneys in children during the 1st year of life, following primary smallpox vaccination and administration of pertusis-diphtheria-tetanus vaccine]." Vopr Okhr Materin Det 1968 Mar; 13(3):79-80, [Article in Russian]

Vaccines and Skin Disorders Citations: Illingsworth R, Skin rashes after triple vaccine," Arch Dis Child 1987 Sep; 62(9):979.

Lupton GP, "Discoid lupus erythematosus occurring in a smallpox vaccination scar," J Am Acad Dermatol, 1987 Oct; 17(4):688-690.

Kompier, A J, "Some Skin Diseases caused by Vaccinia Virus [Smallpox]," Ned Milt Geneesk T, 15:149-157, May 1962.

Weber, G et al, "Skin Lesions Following Vaccinations," Deutsch Med Wschr, 88:1878-1886, S7 Sept 1963.

Copeman, P W, "Skin Complications of Smallpox Vaccination," Practitioner, 197:793-800, Dec 1966.

Denning, DW, et al, "Skin Rashes After Triple Vaccine," Arch Disorder Child, May 1987, 62(5): 510-511.

Vaccinations and Abcesses: Sterler, HC, et al, "Outbreaks of Group A Steptococcal Abcesses Following DTP Vaccination", Pediatrics, Feb 1985, 75(2):299-303.

DiPiramo, D, et al, "Abcess Formation at the Site of Inoculation of Calmette-Guerin Bacillus (BCG)," Riv Med Aeronaut Spaz, Jul-Dec 1981, 46(3-4):190-199.

Vaccinations and Shock: Caileba, A et al, "Shock associated with Disseminated Intravascular Coagulation Syndrome following Injection of DT.TAB Vaccine, Prese Med, Sept 15, 1984, 13(3):1900.

See also the following:

Pathel, JC, et al, "Tetanus Following Vaccination Against Small-pox", J Pediatr, Jul 1960; 27:251-263.

Favez, G, "Tuberculous Superinfection Following a Smallpox Re-Vaccination", Praxis, July 21, 1960; 49:698-699.

Bonifacio, A et al, "Traffic Accidents as an expression of "Iatrogenic damage", Minerva Med, Feb 24, 1971, 62:735-740.

Baker, J et al, "Accidental Vaccinia: Primary Inoculation of a Scrotum", Clin Pediatr (Phila), Apr 1972, 11:244-245.

Edwards, K, "Danger of Sunburn Following Vaccination", Papua New Guinea Med J, Dec 1977, 20(4):203.

Stroder, J, "Incorrect Therapy in Children", Folia Clin Int (Barc), Feb 1966, 16:82-90.

Wehrle PF, "Injury associated with the use of vaccines," Clin Ther 1985;7(3):282-284.

Alberts ME, "When and where will it stop", Iowa Med 1986 Sep; 76(9):424.

Breiman RF, Zanca JA, "Of floors and ceilings - defining, assuring, and communicating vaccine safety", Am J Public Health 1997 Dec;87(12):1919-1920.

Stewart, AM, et al, "Aetiology of Childhood Leukaemia", Lancet, 16 Oct, 1965, 2:789-790.

Nelson, ST, "John Hutchinson On Vaccination Syphilis (Hutchinson, J)", Arch Derm, (Chic), May 1969, 99:529-535.

Mather, C, "Cotton Mather Anguishes Over the Consequences of His Son's Inoculation Against Smallpox", Pediatrics, May 1974; 53:756.

Thoman M, "The Toxic Shot Syndrome", Vet Hum Toxicol, Apr 1986, 28(2):163-166.

Johnson, RH, et al, "Nosocomial Vaccinia Infection", West J Med, Oct 1976, 125(4):266-270.

Heed, JR, "Human Immunization With Rabies Vaccine in Suckling Mice Brain," Salud Publica, May-Jun 1974, 16(3): 469-480.

Tesovic, G et al, "Aseptic Meningitis after Measles, Mumps and Rubella Vaccine", Lancet, Jun 12, 1993, 341(8859):1541.

Buddle, BM et al, "Contagious Ecthyma Virus-Vaccination Failures", Am J Vet Research, Feb 1984, 45(2):263-266.

Freter, R et al, "Oral Immunization And Production of Coproantibody in Human Volunteers", J Immunol, Dec 1963, 91:724-729. [Guess what copro- means .... Feces.]

NA, "Vaccination, For and Against", 1964, Belg T Geneesk, 20:125-130.

Sahadevan, MG et al, "Post-vaccinal Myelitis", J Indian Med Ass, Feb 16, 1966, 46:205-206.

Castan, P et al, "Coma Revealing an acute Leukosis in a child, 15 days after an Oral Anti-poliomyelitis Vaccination," Acta Neurol Bekg, May 1965, 65:349-367.

Stickl, H, et al, "Purulent [pus] meningitides Following Smallpox Vaccination. On the Problem of Post- Vaccinal Decrease of Resistance", Deutsch Med Wschr, Jul 22, 1966, 91:1307-1310. — Preceding unsigned comment added by Pottinger's cats (talk • contribs) 05:05, 9 January 2012 (UTC)

Here is a List of cattle breeds Noformation Talk 05:33, 9 January 2012 (UTC)
Apparently you are unfazed by such a serious issue. This is very unfortunate.Pottinger's cats (talk) 05:57, 9 January 2012 (UTC)
I just thought we were posting lists of things we couldn't possibly expect other editors to read. Protip: if you want to be taken seriously here, make succinct and concise comments that have to do with specific improvements to the article and do so in a couple paragraphs or less. There's no way you can possibly expect posting a list like that to have any positive effect on the article, nor that other editor's lives are so bland and empty that they would jump to the chance to read 100 random publications that some guy on the internet posted because he doesn't like the way wikipedia policy is structured. Noformation Talk 06:04, 9 January 2012 (UTC)
Oh, but before you do, please read the following policies in their entirety: WP:NPOV, WP:MEDRS, WP:OR and WP:FRINGE. Wikipedia has an intricate set of policies and guidelines, as well as community established consensus on how they are interpreted. Most people who don't learn those policies don't do very well here and it really just causes headaches all around. Noformation Talk 06:08, 9 January 2012 (UTC)

Navel glazing

After careful thought, advice from an expert fellow editor, re-reading of some comment-archives and WP:guidelines and trying to understand their spirit, and after contemplation of my umbilicus: will not use revert. But will argue if this remark is deemed off-topic and sectioned, too. See also my older comment, immediately above the WP is not a forum note above, under Appeal and dated 13 December 2011. Rules are there to be broken, very occasionally and, as I said, afer careful thought. I wanted to bold the careful as well, but leave it italic. Carries more weight, counter-intuitively. Sleuth21 (talk) 11:03, 9 January 2012 (UTC)

Tim Minchin comments

The Tim Minchin comments were WP:UNDUE. Or, more broadly, the random comments of any given comedian about alt. med. are WP:UNDUE. Minchin is not a recognized authority on the subject, he is not directly involved in major legislation or campaigns related to it, and thus his opinion simply isn't important. As such, it violates WP:NPOV to include his comments here.Vitaminman (talk) 18:37, 6 March 2012 (UTC)

Yes, that seems reasonable. MastCell Talk 19:06, 6 March 2012 (UTC)
Thanks Vitaminman. It's about time. Maybe there is still hope for this article after all... Gandydancer (talk) 21:28, 6 March 2012 (UTC)
I object to stripping longstanding, good, and properly-sourced material from the article. Maybe it could be presented better, but it's still worth keeping. Notable individuals don't have to be "authorities" when their POV are well-known and highly publicized. Maybe it would be best to also include the numerous sources that quote Minchin. He's a well-known skeptic who just happens to use comedy to get his point across. His work is part of major campaigns to raise awareness of the inroads of unscientific practices into universities, and the campaigns have worked. Major universities in the UK have dropped their degree programs in alternative medicine as a result.
Let's not allow those who wish to use this article for promotion to whitewash it of criticism and thus violate NPOV. The inclusion of criticism is not "undue". It's a requirement! -- Brangifer (talk) 16:58, 7 March 2012 (UTC)
I don't think it's a matter of removing all criticism, just a matter of determining which criticisms are substantial enough to warrant inclusion. If Minchin's commentary on the subject has had substantial national or international visibility and impact, then perhaps it's worth including, but the existing source didn't demonstrate that. His criticism was just sourced to a blog on a movie's promotional website, and under those circumstances I'd agree with Vitaminman's concerns about WP:WEIGHT and notability. MastCell Talk 17:22, 7 March 2012 (UTC)
Minchin is a quite notable comic promoting scepticism and that quote is oft repeated. I would also say that presenting one article from the Washington Post as the entirety of the popular press' reception is (massively) undue weight. In fact I would guess that far more people are aware of Minchin's take on alternative medicine than the number of people who have read that one particular article. ← Randomnonsense talk 22:26, 7 March 2012 (UTC)
To be very non-rigorous, the Guardian ranks significantly higher in Alexa rankings than the Washington Post. Here is Minchin's poem being promoted in the Guardian, ergo Minchin wins in the notability standings and should not have been removed while leaving the Post's article. ← Randomnonsense talk 22:44, 7 March 2012 (UTC)
I think a serious effort to document the "reception" of alternative medicine needs to cast a broader net. In the U.S. alone, a wide range of responses are evident in a brief perusal of the scholarly literature, ranging from those of academic experts on CAM like Barrie Cassileth and Edzard Ernst to this perspective from last week's New England Journal of Medicine. It's obviously a challenge to decide which sources to choose, but I think we can do better than Guardian vs. Post. MastCell Talk 00:34, 8 March 2012 (UTC)
I was not attempting to be too serious, merely indicating that removing Minchin's quote while leaving one article from the Post to constitute the entirety of the popular press section was an untenable position. Going by the earlier reasoning, WP:UNDUE and WP:NPOV also must apply to the Post article and it should be removed, but I would much rather that the section were expanded greatly in which case the Minchin quote may possibly return. ← Randomnonsense talk 01:04, 8 March 2012 (UTC)
P.S. Not too sure why you are looking at the scholarly press for a popular press section. ← Randomnonsense talk 01:09, 8 March 2012 (UTC)
Hmm, I added a couple of articles thinking that the heading, "Characterization", meant reception, but the start of this section indicates that it is meant to mean the definition of alternative medicine. However, much of the "Scientists" subsection seems to mostly describe how alternative medicine has been received. I think this section should be renamed "Characterization and reception", or portions of it should be spun off into a separate reception section, otherwise some of the content doesn't make sense. ← Randomnonsense talk 02:23, 8 March 2012 (UTC)
IIRC (from several years ago), we were dealing with the question of defining alternative medicine, and since there are various definitions, Minchin's was included as one of the most succinct summations of the skeptical POV as also expressed by notable scientists and medical authorities. He summed up the skeptical POV better than anyone, and he happens to be quoted widely for that reason. That he's also funny doesn't hurt a bit, or make what he's saying any less serious. He's dead serious, and is taken seriously. He's the intellectual's comedian. He does for the skeptical POV the same thing that John Stewart and Stephen Colbert do for the liberal political POV...they get their points across using humor, which has proven to be a more effective way than many serious attempts, and thus they have more "weight" in the real world. -- Brangifer (talk) 05:51, 8 March 2012 (UTC)
I agree, I see no good reason to excise the quote. Vitaminman's reasons for its removal are simply incorrect or improper. Here is Minchin being characterized as a poster boy for the sceptical movement. Here is another article showing Minchin taking part in a major sceptical event alongside James Randi, Richard Dawkins, PZ Myers and Simon Singh. By any metric Minchin's quote is more notable than one article from the Washington Post that isn't even an editorial. ← Randomnonsense talk 16:37, 8 March 2012 (UTC)

Remove unsourced copy

This statement Some researchers in alternative medicine object to this categorization, preferring to emphasize differences of approach, but nevertheless use the term CAM, which has become standard.[3][9] is not backed by the sources. I removed it. Gandydancer (talk) 21:26, 6 March 2012 (UTC)

I don't have time to examine this right now, but I suggest you stop your efforts to whitewash the article of criticism (a violation of NPOV) and instead use your efforts to improve the article. You removed good sources. Bad move. Instead you should attempt to get the text to fit the sources. They were included for a reason. What do they say? -- Brangifer (talk) 17:01, 7 March 2012 (UTC)
From the cited interview, "The umbrella term 'CAM' is almost nonsensical. The various modalities have very little in common. Distinction is therefore essential." Ernst uses the phrase CAM throughout the interview, supporting the second bit of the removed text. Gandydancer has misrepresented the sources. ← Randomnonsense talk 22:53, 7 March 2012 (UTC)
Gandydancer's second removal seems somewhat reasonable. The removed text is presented as a quote, but is actually an amalgamation of two different portions of the cited archived page. The current page no longer contains this content, only the archived page does (in conflict with the tense of the removed text). However, it would have been better if Gandydancer updated the text to reflect the source, as is entirely possible and I'll do so now. The example NCCAM now gives of complementary medicine is "using acupuncture in addition to usual care to help lessen pain". ← Randomnonsense talk 23:21, 7 March 2012 (UTC)
I suspected as much and am not surprised. Good solution. -- Brangifer (talk) 05:52, 8 March 2012 (UTC)

This article is biased

Collapse conspiracy theory driven soapoboxing

This is perhaps one of the most biased articles I have ever read on Wikipedia. It is obviously written by people who know nothing about the topic and are merely trying to discredit alternative medicine so as to prop up Big Pharm and the anti-scientific cult of conventional medicine. — Preceding unsigned comment added by 70.109.179.244 (talk) 03:46, 11 March 2012 (UTC)

"Based on historical or cultural traditions, rather than on scientific evidence" statement in lead

I've added a citation needed tag re. the "based on historical or cultural traditions, rather than on scientific evidence" statement in the lead. Not that I doubt someone will be able to dredge something up to claim proof of this, of course, just that I think the article shouldn't get away with saying this without providing proper supporting evidence per WP:RS. Vitaminman (talk) 19:02, 15 March 2012 (UTC)

In a recent edit, Saedon says that a citation tag is not needed here per WP:LEDE and that the "topic is sourced and discussed in the article." Unfortunately he does not cite where. Having searched the refs for a source re. this statement, but not found one, I have replaced the tag. Vitaminman (talk) 18:21, 24 April 2012 (UTC)

Free issue of FACT

The latest issue of FACT provides full access to multiple interesting articles that can be used here and in other relevant alt med articles (the PDFs are often good):

Brangifer (talk) 19:13, 25 March 2012 (UTC)

Reads like an extended attack piece

Hey folks. Although this is a controversial topic, the sheer number of criticisms contained in this article, and the tendency to lump a variety of sometimes-unrelated practices together under one monolithic 'alternative' heading, seems to suggest that contributors have actively used this article as a soapbox against anything that isn't allopathic medicine. About midway through reading the piece, it became evident that criticisms were simply being 'piled on'. Without taking a stand either way, I would say this article is in need of a serious rewrite. A mainstream view of the subject could still be adequately presented using far fewer individual criticisms, and in a more NPOV tone. As proof of bias, I would point readers in the direction of http://en.wikipedia.org/wiki/Iatrogenesis That article, which points out that the practice of allopathic medicine is the third or fourth leading cause of death in the United States, garners little by way of comment or controversy in comparison. 199.7.156.34 (talk) 18:36, 21 April 2012 (UTC)

We give due weight to reliable sources, not original research. As an aside, there isn't likely to be medical complications from, for example, taking homeopathic water (except accidental drowning) as it does nothing (except perhaps issues from lack of treatment: [17]). IRWolfie- (talk) 19:30, 21 April 2012 (UTC)
I'll echo what IRWolfie said and note that the side effects (sometimes fatal side effects) of properly-prescribed, properly-administered medications are generally well-understood, and a consideration in deciding whether or not they should be used. The appropriate question to ask in considering risk is not 'how many people will die from the effects of this drug?' (which is the number tabulated in iatrogenesis), but rather 'how many more or fewer people will die if given this drug, compared to the best alternative therapy?'. To fabricate an illustrative example using entirely made-up numbers, suppose we have a group of patients presenting with myocardial infarction (heart attack); without intervention, let's say 50% of them will die. We can treat the patients with a thrombolytic agent (clot-busting drug); let's say it saves half of those (25%), but it also causes fatal bleeding in 5%. Overall, then, 70% of patients survive when the drug is used, whereas only 50% survive without it—but 5% of patients are reported as having an iatrogenic contribution to their cause of death. TenOfAllTrades(talk) 20:02, 21 April 2012 (UTC)
Yup, 199.7.156.34, hang around a little while and you'll soon learn that this approach is pretty much the norm here... ;-) Vitaminman (talk) 18:09, 24 April 2012 (UTC)

Use of CAM by cancer patients

The 3rd paragraph in the lead currently reads "1998 systematic review of studies assessing its prevalence in 13 countries concluded that about 31% of cancer patients use some form of complementary and alternative medicine." This study includes various practices which would hardly be considered "alternative" to most MDs. Specifically, the study includes diet and exercise as a form of CAM. Obviously, exercise isn't a replacement for chemo, but its a form of "therapy" which is well-grounded in science. I believe we either need to clarify this in the article; or, if that's too cumbersome, the sentence could be deleted altogether.JoelWhy (talk) 15:36, 8 May 2012 (UTC)

Seconded. a13ean (talk) 16:51, 8 May 2012 (UTC)
I agree; also, I am virtually certain that there are more up-to-date estimates of CAM use among people with cancer. I'll look around for something to replace the current reference. MastCell Talk 17:10, 8 May 2012 (UTC)

University of Aberdeen avoids "quackery" accusation

Times Higher Education

The University of Aberdeen ducked any further accusations of promoting "quackery" by deciding against establishing a chair in a form of alternative medicine ...

http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=419947&c=1

Brangifer (talk) 04:10, 21 May 2012 (UTC)

That's too bad, as I was hoping to subsequently apply to become the Chair of Magic based on my degree from Hogwarts...JoelWhy (talk) 13:24, 21 May 2012 (UTC)

Which Complementary and Alternative Therapies Merit Study? - Medscape

Interesting article:

Brangifer (talk) 02:19, 23 May 2012 (UTC)

Studying Complementary and Alternative Therapies - JAMA

Another interesting article:

Brangifer (talk) 03:49, 23 May 2012 (UTC)

A "Viewpoint", yes, but not an especially interesting, or even original, one. Vitaminman (talk) 08:42, 25 May 2012 (UTC)

Clinical outcomes for cancer patients using complementary and alternative medicine - Altern Ther Health Med.

Another interesting article:

Vitaminman (talk) 20:41, 24 May 2012 (UTC)

Yes, published in the prestigious Alternative Therapies In Health And Medicine journal...JoelWhy (talk) 20:44, 24 May 2012 (UTC)
Although the authors state in the abstract that CAM use "provided an absolute reduction of infection episodes", what they really mean is that CAM use was associated with a lower infection risk. Obviously, you can't seriously consider assigning causality on the basis of a retrospective cohort study which made no apparent attempt to control for possible confounding variables.

It's difficult to comment further without the full text, which I'll have to dig up, but the abstract raises some interesting questions. For example, if patients using CAM died more quickly, they would likely have a lower infection rate - because once you die, you can't get any more infections. I'm ordinarily willing to give authors the benefit of the doubt that they've handled these sorts of competing risks appropriately, but my experience with the alt-med literature has led me not to assume anything of the sort, particularly as the authors rather surprisingly failed to comment on survival or overall mortality in the cohort in the abstract. MastCell Talk 23:53, 24 May 2012 (UTC)

(Also commenting without looking at the specifics) I find it odd that they are commenting on antibiotics use and infections, as opposed to say, cancer mortality, all-cause mortality or some other endpoint that's more relevant. Smells like one of those statistical fishing expeditions where they analyze 50 variables and (shockingly) find two or three are "statistically significant"... Yobol (talk) 00:15, 25 May 2012 (UTC)
I haven't read the actual study (only the abstract is available for free, AFAIK.) However, based on the information provided, no definition of CAM is given. Some of these studies classify things like diet and exercise as CAM. So, if you study how people who (a) improved their diet, (b) increased the amount of exercise, and (c) began to drink magic water, and then they do better than those who made no such changes, these researchers conclude that the magic water must have worked. Brilliant!JoelWhy (talk) 12:33, 25 May 2012 (UTC)
Based on the abstract and the first few paragraphs (free preview of the first page only at [18]), it's almost certainly a statistical fishing expedition: "The authors collected data on clinical characteristics for each patient and assessed the differences between each characteristic at baseline...and at 6 months after baseline measurement." In other words, in this retrospective study they took all 357 case files, compared every measure that was reported in each, and kept plugging away until they found a spurious statistical 'significance' on one of the metrics. They then went further and performed a 'subgroup analysis' on the one measure where they had spurious significance in order to show a more dramatic benefit for the metastatic disease subgroup; even if you randomly divide a group that has a marginal effect in it, you're likely to end up with one subgroup showing a larger effect (while the other group(s) show a smaller effect). I suspect that if they had been presenting 95% confidence intervals instead of just p-values, it would be much more conspicuous just how wobbly these putative effect sizes are.
The authors appear to have lumped together all uses of 'oral CAM', which included any and all of "'food supplements..., traditional Chinese medicine (TCM), special diets, and vitamins." I suspect that their samples wouldn't have been large enough to produce statistical significance for anything if they didn't pool all those disparate therapies into one 'CAM' group. I'm not going to cough up $15 to read the entire study, as the dubiousness is already apparent from the first page. TenOfAllTrades(talk) 13:28, 25 May 2012 (UTC)

Final paragraph of Lede

At present, the first sentence of the final paragraph of the Lede says: "Claims about the efficacy of alternative medicine tend to lack evidence, and have been shown to repeatedly fail during testing." This sentence seems to contain weasel words doesnt appear sourced, nor does it seem accurate. There is a source later in the body of the article, under evidence, that says: "A 2005 review of 145 alternative medicine Cochrane reviews using the 2004 database revealed that 38.4% concluded positive effect or possibly positive (12.4%) effect, 4.8% concluded no effect, 0.69% concluded harmful effect, and 56.6% concluded insufficient evidence."[4]: 135–136  Thus, the Lede does not accurately summarize the body of the artice. I propose changing the current first sentence of the last paragraph of the Lede with a more accurate statement without weasel words, such as: "Some of the claims about the efficacy of alternative medicine are controversial and only one-third of alternative treatments have evidence to support their use."Puhlaa (talk) 15:16, 7 September 2012 (UTC)

I totally agree with you! Lova Falk talk 16:45, 7 September 2012 (UTC)
That raises a couple of interesting points. The cited source (an 2005 Institute of Medicine report) goes on to note that the prevalence of low-quality trials with positive results exaggerates the effectiveness of CAM (p. 143), and that "most trials of homeopathy, herbal medicine, and acupuncture had major problems with their reporting and the study methodology." (p. 144) In other words, the source's conclusion is quite a bit more nuanced than simply reporting the percentage of published clinical trials showing positive results.

Secondly, the positive trials of "alternative medicine" described in the Cochrane review include a number of trials showing that calcium +/- Vitamin D is effective in preventing bone loss, that iron supplementation is useful in pregnancy, or that folate supplementation in pregnancy reduces the risk of neural-tube defects in children. It's debatable whether those are truly trials of "alternative medicine", since these uses have been accepted and well-established parts of mainstream medicine for quite some time and are probably not the sorts of things people have in mind when they talk about "alternative medicine". If you remove those trials from the analysis, the effectiveness statistics look quite a bit poorer. But anyhow... MastCell Talk 17:14, 7 September 2012 (UTC)

MastCell, with regard to your second point, I would say that if 'Cochrane' called it an 'alternative therapy' in their review, then unless a good source contradicts this, we call it alternative here (be it calcium/Vit D/iron or other). Thus, I dont agree that this is a issue. However, with regard to your first point, quality of studies, I would not be opposed to qualifying the proposed statement in the Lede with something in the order of "...,however there are notable issues with some of the research methods used." or something like that. Either way, the sentence under scrutiny needs a source and should be made to better align with the content in the body. 'Cochrane' doesnt seem to agree that 'most therapies fail during testing'. Puhlaa (talk) 18:52, 7 September 2012 (UTC)
Yeah, I brought up the second point (about the definition of "alternative" therapies) mostly as a point of personal interest (although the IOM report does spend a lengthy footnote detailing how they defined "alternative" for these purposes). It would be interesting to see a Cochrane update, as there have been quite a few large, major randomized trials of alternative therapies with negative results in the past several years (e.g. SELECT, gingko biloba for the prevention of dementia, etc.) MastCell Talk 20:23, 7 September 2012 (UTC)
I do not believe there is an updated version of the 2005 report, however, I agree that it will be interesting to see it when it happens! In the meantime, I have not seen anyone disagree that the existing sentence is unsourced and not representative of the body of the article. Below I have suggested an alternate way to start the last paragraph of the Lede, please make suggestions on how to improve it further.Puhlaa (talk) 03:53, 8 September 2012 (UTC)
  • Many of the claims regarding the efficacy of alternative medicines are controversial. While one-third of alternative treatments have evidence to support their use, there often exists problems with the research methodology used, which might cause these results to be exaggerated.(ref)
As no one has disagreed that the first sentence of the last paragraph of the lede is unsourced and inconsistent with the body of the article, I will go ahead and make the change proposed above.Puhlaa (talk) 14:50, 14 September 2012 (UTC)

Eh, SELECT was just a pointless waste of money, as the participants were all replete in selenium (which, if I recall correctly, wasn't even a footnote in the published report). This kind of stuff is very damaging as many medical professionals interpreted it as contradicting an earlier trial which found that selenium prevents cancer in those with marked deficiency). With regard to ginkgo biloba: there are lots of much better interventions, e.g. alpha-GPC or rhodiola rosea which could have been investigated and would likely fall under 'alternative medicine'. It's truly astonishing that ginkgo biloba was selected out of all the promising treatments. Saw palmetto extract is a better example of a notable recent failure. I actually added the cite to Cochrane's 2005 study. I agree with MastCell's overall point, especially in terms of the definition of alternative medicine. However, defining it as only interventions which aren't evidence-based is obviously problematic. Does that mean that the 30% or so of mainstream medical interventions which aren't evidence-based are actually alternative medicine? As my comments about the trials above show, our medical institutions are hardly perfect. The "fringe" of alternative medicine hardly has a monopoly on bad medical decision-making. Alternative medicine includes quite a lot of interventions (mostly herbal/nutritional or lifestyle-based) with decent or highly promising evidence and low side-effect risk which are flat out ignored by the industry, and therefore by doctors who are highly reliant upon the industry to learn about therapies. Many doctors are so deeply afraid of being viewed as quacks that they reflexively reject anything which doesn't come at a huge price tag and a long list of side-effects. II | (t - c) 01:38, 8 September 2012 (UTC)

Might I suggest that we not have a general "efficacy" section in this article at all? Clearly there are positive results for some areas more than others, and lumping them all together is not something that is generally done in the medical literature. This makes as much sense as talking about the efficacy of antibiotics in general as opposed to their utility in specific situations (great for pneumonia, not so much for heart attacks). Yobol (talk) 22:26, 9 September 2012 (UTC)
This could work, provided we remove every reference to efficacy altogether, both negative and positive. It would then be up to the individual alt med articles to discuss the respective efficacy. This could be difficult however, because most of the criticism of alt med is with regard to exagerated claims of efficacy. I doubt that many editors would be satisfied with removing the criticism of the claims of efficacy from the article.Puhlaa (talk) 00:28, 10 September 2012 (UTC)
Or we could only mention those efficacy that have been extensively studied and reported on in specific areas (i.e. alt med for cancer, etc). I think a general discussion of efficacy makes little sense; subdividing it into specific areas makes much more sense, or having no discussion at all. Yobol (talk) 02:52, 10 September 2012 (UTC)
Subdividing it by area is a good idea. Not sure if there's anything good in that vein, but I agree that overall statistics are not very helpful. II | (t - c) 03:17, 10 September 2012 (UTC)

Additional reliably sourced content needed re criticism of evidence based medicine by some alt med practitioners

Recent edits added content from about ten major scientific journals, such as Annals of New York Academy of Sciences and Journal of Academic Medicine, . There is a need for additional information in the lead section, such as regarding many alternative medicine practioners claims that conventional "science doesn't measure everything" (e.g., types of health that are more general, or are specific to a single patient, and thereby not subject to a scientific methodolory involving multiple subjects, and thereby only detectable by a one-on-one relationship between doctor and patient), on defects and inconsistencies in the scientific method, and other clearly valid points. A problem I am having with sourcing this is that there is such a diversity of alternative medical practices, that no source from the diverse group appears to be reliable in speaking for a community that does not recognize that one source as speaking for their own position. I would support adding this kind of material to the lead since it is on point to the article topic, and ask for assistance in sourcing it. Please discuss. ParkSehJik (talk) 19:16, 8 November 2012 (UTC)

The lead is meant to summarize the article. The lead is not meant to advance new points. Perhaps some of what you propose belongs on Alternative_medicine#Criticism. IRWolfie- (talk) 19:19, 8 November 2012 (UTC)
Yes, you are correct that it belongs in the lead only if it is a big part of the article body. But it does not belong in a criticism section, since it is the opposite of criticism of alternative medicines. It is a criticism by alternative medicine practitioners of the scientific method. I have clarified this by changing the section header above. ParkSehJik (talk) 19:31, 8 November 2012 (UTC)
Perhaps you could suggest a lead edit with a RS here and we could all discuss it. Keep in mind that the lead should generally not even need to be sourced because it is expected that anything in the lead is well-covered in the body of the article--so perhaps you should start with info that you'd like to see in the body? Gandydancer (talk) 00:19, 10 November 2012 (UTC)
On fringe articles it ends up being generally sourced because fringe proponents usually try and remove any unsourced criticism, even if it essentially repeats the body of the text. IRWolfie- (talk) 20:39, 10 November 2012 (UTC)
Can you clarify for us if you are editing here as a proponent or opponent?Qexigator (talk) 21:50, 10 November 2012 (UTC)
I hope people are editing as wikipedians. IRWolfie- (talk) 00:04, 11 November 2012 (UTC)

Removal of one possible definition

While I agree that CAM is difficult to define, a recent edit removed one very valid definition of CAM, ie: "Alternative medicine is any practice claiming to heal that does not fall within the realm of conventional medicine" The rational being that the editor doesnt think this is correct and the source is weak. I dont need to detail why the editor's opinion is insufficient cause for removal of this text, however, as this is a common and valid definition, I have addressed the second concern by providing some better sourcing options:

  1. WHO [19]: The terms "complementary medicine" or "alternative medicine" ... refer to a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.
  2. NCCAM [20]: NCCAM defines CAM as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.
  3. Peer-reviewed article in British Medical Journal[21]: a group of therapeutic and diagnostic disciplines that exist largely outside the institutions where conventional health care is taught and provided.
  • Note: A search of recent, mainstream, peer-reviewed, secondary sources reveals that the NCCAM definition is commonly accepted. Here are a couple examples for evidence of this. [22][23]

Thus, I agree with the addition of new text that states that "CAM is difficult to define", however, I request that the very common and mainstream definition that was removed be re-added.Puhlaa (talk) 01:29, 11 November 2012 (UTC)

Done. Also, "CAM is difficult to define" is unreferenced, so it can go.TippyGoomba (talk) 04:30, 11 November 2012 (UTC)

Trimming subtopic

One or two editors may be aware of a continuing discussion at Talk:Science about including subtopics such as "criticism", arising from an excessive delete. One of the comments, referring to WP:Summary style, could be applicable here. It remarked that the criticism section was overlong and the article would be improved by retaining a brief criticism section there while trimming the text by about 20% and leaving the details to the linked pages. In principle this also applies to "Alternative medicine". For ease of writing and speaking it is usually convenient to use terms such as "mainstream" and "alternative" but editors generally will be aware that the practise of healing, in the name of Medicine, is not exclusively the province or domain of the kind of "science" which is anxious for its own reasons to be distinguished from what used to be known as "natural science" or "natural philosophy". The all round view appropriate to Wikipedia needs particular care when reporting unpopular or minority topics, which may in time join the curiosities of history or be seen as contributing to a new found reform. Qexigator (talk) 08:46, 12 November 2012 (UTC)

Irrelevant here. The issue at the science article was undue weight. With this topic, a very substantial proportion of the coverage in reliable sources is criticism, and to downplay that would violate WP:WEIGHT. The rest of your argument is run-of-the-mill special pleading, bordering on POV pushing. Nothing there worth even considering. Dominus Vobisdu (talk) 10:55, 12 November 2012 (UTC)

Anyone can see for him/her -self that DomVob's remarks above, separately and together, are mistaken or irrelevant and baseless as regards the opening paragraph here, and may see that his/her "argument is run-of-the-mill special pleading, bordering on POV pushing. Nothing there worth even considering" to use that turn of phrase. Constructive comment from editors wishing to improve the article would, of course, be welcome. Qexigator (talk) 21:14, 12 November 2012 (UTC)

  • I actually think this article is overly biased towards alternative medicine, and the current article unduly legitimises it. IRWolfie- (talk) 00:55, 13 November 2012 (UTC)
Indeed, the whole article should be a criticism section, otherwise we can just redirect to Medicine and be done with it. TippyGoomba (talk) 02:49, 13 November 2012 (UTC)
I agree, page should have a heavy hand taken to it. Sgerbic (talk) 04:21, 13 November 2012 (UTC)

It is really a question of good practice in distributing the relevant information between the articles, with cross-ref. links, redirects and disambigs. for the convenience of readers. Given the topic (Alternative medicine), to one who is an empirical sceptic indiscriminate remarks such as the following: _"the article unduly legitimises" the topic, _"we can just redirect to Medicine and be done with it", _"should have a heavy hand taken to it" indicate that, for the sake of editorial practicality, while "Alternative medicine" may well be seen to be within the scope of "medicine", and seeing that the article "Medicine" has the section "Criticism of modern medicine", the Medicine article itself needs some protection from overload. Hence retaining a separate article for AM may be preferable, where points for and against and neutral can be succinctly stated without overt or implicit polemic. Would that be done adequately in "Medicine"? Qexigator (talk) 09:01, 13 November 2012 (UTC)

Your "points for and against" comment makes it seem like you think of WP as some sort of "neutral" debating forum where each side is "fairly" allowed to get up on their own soapbox and make a direct plea to the general public in their own words, after which the general public makes up their own mind. If that's the case, you're sorely mistaken and at total odds with WP policies and guidelines, especially WP:WEIGHT, WP:GEVAL, WP:FRINGE and WP:SOAPBOX. Dominus Vobisdu (talk) 14:17, 13 November 2012 (UTC)

DomVob's comment is as far off the mark as the origin of Straw man is obscure. How odd. Qexigator (talk) 16:00, 13 November 2012 (UTC)

You are creating a false equivalence by comparing this article to medicine and science. These topics do not have a comparable sort of coverage in the reliable sources. IRWolfie- (talk) 19:09, 13 November 2012 (UTC)

Another failure to read as written-- perhaps another instance of straw manning: even odder. Qexigator (talk) 23:04, 13 November 2012 (UTC)

What's really odd is that you've failed to notice that you have failed to get consensus for your proposal, or to spark any interest among the four editors responding. Quite the opposite in fact. If people are "misreading" your argument, perhaps you should consider whether you have "miswritten" it. In any case, I can't see any point in further discussion. You've lost my ear. Dominus Vobisdu (talk) 23:21, 13 November 2012 (UTC)

No claim to consensus has been made, and the comments of the four editors, including DomVob's assurance that s/he can't see any point in further discussion, has not been unremarked by...Qexigator (talk) 23:47, 13 November 2012 (UTC)

The lead is top-heavy

"The lead is meant to summarize the article" per IRWolfie 8 November 2012. Given that the main topic is simply "Alternative medicine" and not "The current controversy about 'alternative medicine' " the lead seems to be topheavy, and in point of editing parts of it would be better placed in later sections (leaving aside the sourcing and NPoV questions mentioned above), perhaps as follows, showing by "...1/2/3... " parts omitted for placing later in the article, enumerated below for ease of reference.

--PS, added In view of certain later comments on this page: The article has been declared of interest to four WikiProjects, 1_Alternative medicine, [[24]], [[25]] 2_Medicine, [[26]], [[27]] 3_Rational Skepticism[[28]],(Portal:Philosophy of science) and 4_ Alternative views. [[29]] Editors will be aware that this results from a continuing tension among those who engage themselves in formulating and applying "policy", which reflects a tension among the world wide readership generally, namely, between those who would hold that "science" (in all aspects) is within the scope of (or in some way a branch or extension of) epistemology, and those who hold the opposite or something else. The proposal here is neutral about any of that, and is merely concerned with the convenient distribution, arrangement and editorial presentation of the information. Qexigator (talk) 10:45, 14 November 2012 (UTC)
  • Alternative medicine is any practice claiming to heal "that does not fall within the realm of conventional medicine."[1] Alternative medicine is frequently grouped with complementary medicine or integrative medicine, which, in general, refers to the same interventions when used in conjunction with mainstream techniques,[2][3][4] under the umbrella term complementary and alternative medicine, or CAM.[5][6] ... 1.... Alternative medicine varies from country to country......2...... Alternative medicine methods are diverse in their foundations and methodologies. Methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, or newly conceived approaches to healing.[13] Many of the claims regarding the efficacy of alternative medicines are controversial.....3....
_1 Critics maintain that the terms “complementary” and “alternative medicine” are deceptive euphemisms meant to give an impression of medical authority.[7][8][9] A 1998 systematic review of studies assessing its prevalence in 13 countries concluded that about 31% of cancer patients use some form of complementary and alternative medicine.[10]
_2 Jurisdictions where alternative medical practices are sufficiently widespread may license and regulate them. Edzard Ernst has said that in Austria and Germany complementary and alternative medicine is mainly in the hands of physicians,[5] while some estimates suggest that at least half of American alternative practitioners are physicians.[11] In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance based on their Commission E legislation.[12]
_3 While one-third of alternative treatments have some published literature supporting their use, research on alternative medicine is frequently of low quality and methodologically flawed, which might cause these results to be exaggerated.[14]. Qexigator (talk) 09:39, 10 November 2012 (UTC)

Excellent suggestion. I vote yes. TimidGuy (talk) 09:57, 10 November 2012 (UTC)

  • I think the lead is now fine for its size. IRWolfie- (talk) 11:57, 10 November 2012 (UTC)
I can't see where anything has been left out; things seem to be just moved around. This: Critics maintain that the terms “complementary” and “alternative medicine” are deceptive euphemisms meant to give an impression of medical authority.[7][8][9] should be removed from the lead. The Skeptic's Dictionary is not a medical authority and the NEJM article was way overblown in importance. Gandydancer (talk) 12:23, 10 November 2012 (UTC)
No, that would be removal of content indicating the mainstream position. I think it should be worded away from "Critics maintain". We can also use quackwatch too, which is very well respected if you wish. IRWolfie- (talk) 12:25, 10 November 2012 (UTC)
I'm wondering about this one-third comment "While one-third of alternative treatments have some published literature supporting their use, research on alternative medicine is frequently of low quality and methodologically flawed, which might cause these results to be exaggerated.[14]" I don't see where the citation actually says this number.
Chapter 5: 'State of Emerging Evidence on CAM' Page 135 - "The results from all eligible Cochrane reviews of CAM therapies were assigned to one of the following categories.....The largest number of treatments described in the reviews were classified as insufficient evidence of an effect (n = 82; 56.6 percent), followed by positive effect (n = 36; 24.8 percent) and possibly positive effect (n = 18; 12.4 percent)." 24.8% positive effect + 12.4 possibly positive = 37.2% positive or possibly positive effect. Puhlaa (talk) 16:13, 10 November 2012 (UTC)
Also 1998? Isn't there something more current than 14 years ago? "A 1998 systematic review of studies assessing its prevalence in 13 countries concluded that about 31% of cancer patients use some form of complementary and alternative medicine.[10" Sgerbic (talk) 14:26, 10 November 2012 (UTC)
Yes it looks too old for WP:MEDRS for that claim. IRWolfie- (talk) 16:26, 10 November 2012 (UTC)
What about some newer secondary sources that look at CAM use? Heres a newer one looking at Cancer patients [30] Looks like utilization of CAM has increased since the 90s. Heres one on use by the general population [31] Here is one on use by the general pop. and healthcare workers [32] and one for people with CVD [33] Puhlaa (talk) 17:40, 10 November 2012 (UTC)

The moves proposed below are neutral either way, i.e. neither for nor against any of the other points under discussion such as updating sources, and may be helpful for both readers and editors. Qexigator (talk) 18:37, 10 November 2012 (UTC)

  • Proposed moves, noting per IRWolfie "an already bloated lead" (article revision 00:46, 10 November 2012), and "a number of issues that can only be solved by going through the edits block by block in detail" (above 00:51, 10 November 2012)-- Overall and for improving the readability and presentation generally, as well as for convenience of updates and other revisions, propose moves with minor copyedits (and keeping sources as now refd. until any are otherwise altered later) as follows:
_1.1 Some critics maintain that the terms “complementary” and “alternative medicine” are deceptive euphemisms meant to give an impression of medical authority.[7][8][9]"
--to Section "Criticism"
_1.2 "A 1998 systematic review of studies assessing its prevalence in 13 countries concluded that about 31% of cancer patients use some form of complementary and alternative medicine.[10] "
--to Section "Usage"
_2.1 "Jurisdictions where alternative medical practices are sufficiently widespread may license and regulate them.":::--to Section "Regulation"
_2.2 "Edzard Ernst has said that in Austria and Germany complementary and alternative medicine is mainly in the hands of physicians,[5]" to Section "Regulation" (?)
_2.3 (while) "Some estimates suggest that at least half of American alternative practitioners are physicians.[11]"
--to Section "United States"
_2.4 "In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance based on their Commission E legislation.[12]"
--to Section "Regulation" or "Usage"
_3 While one-third of alternative treatments have some published literature supporting their use, critics maintain research on alternative medicine is frequently of low quality and methodologically flawed, which might cause these results to be exaggerated.[14].
--to Section "Criticism"

--Qexigator (talk) 16:57, 10 November 2012 (UTC)

Moves 1.1 and 1.2 now done: please advise or emend if misplaced or otherwise faulty. Qexigator (talk) 20:35, 10 November 2012 (UTC)
You quoted me before I said "Now it's fine". You moved the criticism out and then subtly changed it to "Some critics", which is a weasel. IRWolfie- (talk) 20:37, 10 November 2012 (UTC)
Thank you for responding. Perhaps you could remember that it would be well not to bandy pejoratives or imply bad faith too readily. Your comment re "Now it's fine" not understood, nor your assertion about subtle or weasel. But will await further comment from others. Qexigator (talk) 21:05, 10 November 2012 (UTC)
It is important (according to policy) to include the perspective of both advocates and skeptics in a controversial article, thus, I have no issues with the text that Qexigator removed staying in the lede. However, I do take issue with the sources; I dont believe that skeptic websites are appropriate sources. Is there not a more neutral source that criticises the use of the term CAM?Puhlaa (talk) 21:42, 10 November 2012 (UTC)
Skeptic websites have a reputation for fact checking. If you disagree you can ask at RSN. Alternatively you can also use Quackwatch if you wish. IRWolfie- (talk) 21:47, 10 November 2012 (UTC)
If the skeptical websites were being used as a source for facts that they had checked, then I would agree. However, we are using skeptical websites to support what is simply an opinion by skeptics.... that the term CAM is used "to give a false impression of medical authority".Puhlaa (talk) 21:57, 10 November 2012 (UTC)
They are reliable for that, you can check it at RSN. Bring the text and reference to WP:RSN if you wish, IRWolfie- (talk) 21:59, 10 November 2012 (UTC)

Like the article as it now stands, this thread seems to need untangling. But here are three points arising from above indents. Qexigator's proposed moves are not intended 1_to further any partisan cause for or against; 2_nor to meddle with sources; 3_nor to take any position on the relative or absolute merits of CAM or Quackwatch. My concern is as stated: the lead is top-heavy, and the topic is "Alternative medicine" not "The current controversy about 'alternative medicine' ". Qexigator (talk) 22:06, 10 November 2012 (UTC)

The lead is now within normal sizes for wikipedia articles. IRWolfie- (talk) 00:02, 11 November 2012 (UTC)
--For the time being, and while you (or others) are still working on it, let it be. But a lead should be judged by its quality and character, not by an average, or supposedly normal, measurement of line-age or word-age, or in another medium column inches. Experienced editors (as you are) also know that shorter leads will often suffice for well written and constructed articles. Qexigator (talk) 00:56, 11 November 2012 (UTC)

Alternative definitions of "health"

A major theme in at least some alternative medical practices is the claim that some kinds of health are either not measured, or are incapable of being measured, by scientific methods. For example, "spiritual health". This should be included in the article. Perhaps some editors who are practitioners can suggest sources as to these claims. ParkSehJik (talk) 21:29, 22 November 2012 (UTC)

  1. ^ Cite error: The named reference Newman was invoked but never defined (see the help page).
  2. ^ Cite error: The named reference inquiry_cfm was invoked but never defined (see the help page).
  3. ^ a b Cite error: The named reference Hrob2001 was invoked but never defined (see the help page).
  4. ^ "Complementary and Alternative Medicine in the United States".
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