Talk:Homeopathy/Archive 36

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Final decision in Homeopathy arbitration case

This arbitration case has been closed and the final decision is available at the link above. Any uninvolved administrator may, on his or her own discretion, impose sanctions on any editor working in the area of conflict (defined as articles which relate to homeopathy, broadly interpreted) if, despite being warned, that editor repeatedly or seriously fails to adhere to the purpose of Wikipedia, any expected standards of behavior, or any normal editorial process. The sanctions imposed may include blocks of up to one year in length; bans from editing any page or set of pages within the area of conflict; bans on any editing related to the topic or its closely related topics; restrictions on reverts or other specified behaviors; or any other measures which the imposing administrator believes are reasonably necessary to ensure the smooth functioning of the project. User DanaUllman (talk · contribs) has been banned from Wikipedia for a period of one year. On behalf of the Arbitration Committee, Nishkid64 _{(Make articles, not wikidrama)} 00:34, 1 July 2008 (UTC)

Thank you for takign the time to render a deicison regarding this case. personally I Feel that it would have sufficed to ban DanaUllman only from hoemopathy-related articles indefinitely, but your decision was based on the facts of the case and I hope it wll lead to a cooling of tentions regarding to this page that will eventually lead to a stabilizaiton of the article, a lifting of the probation, and eventually raising hre article back to FA or eve GA status. Smith Jones (talk) 01:53, 1 July 2008 (UTC)

The Lead

sorry to have 'hit and run' a bit with my editing above - but I still feel that the suggestions at Talk:Homeopathy/Lead are better than the lead we currently have... will try and work some of the suggestions above into the sandbox - and also try and merge the two suggested versions, with a view to replacing the lead before too long - I'm afraid I consider the current version rather weak. Privatemusings (talk) 08:11, 30 April 2008 (UTC)

I agree, and I am looking forward to getting a new, more concise lede here. --Hans Adler (talk) 17:57, 3 May 2008 (UTC)

As an engineer and former nonbeliever, I really don't think we shall ever get agreement on the introduction. Homeopathy seems completely impossible and seems to violate the current laws. However, let me remind you that Albert Einstein's work completely obliterated the law of conservation of mass for certain cases. I believe that homeopathy is probably another one of these special cases. I think the best way to fix this page is to present the facts of what homeopathy is. Remove any reference to it working/nonworking and have links to a seperate page(s) to discuss this. I know it works because I have seen it many times, however, I truly understand the skeptic who has never tried it. I suggest that all nonbelivers try it out on themselves but purchasing some Arnica cream and put it on a bruise. In addition, if you want to see some awesome photos of impossible cures go to http://www.dupagehomeopathic.com/ and look at the photos. It really does seem impossible and I will tell you that it is really, really hard to practice. It is harder than any of the toughest engineering problems I faced. However, the results are amazing enough that I quit my Director of Engineering job to practice this very difficult medicine. Dr. Josephine Polich —Preceding unsigned comment added by 70.131.135.121 (talk) 12:47, 16 June 2008 (UTC)

<groan> I am a "skeptic who has never tried it", and you most certainly do *not* understand me. For a scientist (engineers might think differently), anecdotal evidence is the *least reliable* type of evidence, and being first-hand does not make it any better. Regardless of what happens if I try it, I would still believe an RCT over my own experience any day. If we could write the article so that the readers would understand this one point, we would be bringing them a long way toward understanding how science works. We should strive to do that rather than "removing any reference" to this most central of scientific questions. --Art Carlson (talk) 13:17, 16 June 2008 (UTC)

Conservation of energy (mass is, in simple terms, energy) is not broken by Einstein's work, the notion was refined. Removing criticism and the scientific and medical view, the majority view, of homeopathy from the page seems like a bad idea and is contrary to wikipedia's core policies. Also, the last tube of arnica bruise cream I looked at wasn't homeopathic. --SesquipedalianVerbiage (talk) 09:23, 19 June 2008 (UTC)

Yes, I agree that random, double blind placebo controlled (RDBPC)studies are the best and verifying something. However, anecdotal evidence is also important and useful. Generally, they should be followed up by random, double blind studies. However, in the case of homeopathy that is exceedingly difficult because our model of health means that everyone is different. I may treat a person with Eczema with any one of 50 different remedies. We don't diagnose based upon disease but based upon how well they match a single remedy. If we conducted the RDBPC according to the remedy type then we would have better results. It is like trying to referee basketball using the rules of football. To further complicate matters, homeopathy is exceedingly hard to practice. It takes a lot of analytical capability to find the right remedy. Sometimes I simply can't figure out what remedy will work. When I can't match the right remedy, noting works. Now, there are some studies that I am surprised did not work. Arnica is a relatively simple to figure out (and of course you can find homeopathic and nonhomeopathic creams)and I was surprised that there are not tons of positive ARnica studies out there. However, I realized that the Arnica formulation was way too weak for the condition. I really don't know why they did not do a pilot study before hand, but I think it is because few homeopaths have research experience. Dr. Josephine Polich —Preceding unsigned comment added by 70.131.107.176 (talk) 13:39, 25 June 2008 (UTC)

Hi, this isn't the right place for this discussion (talk pages are for discussing the article, not a forum about the topic). However, please feel free to copy your comment to my talk page and I'll discuss it there with you, if you like. --SesquipedalianVerbiage (talk) 13:49, 25 June 2008 (UTC)

I am particularly discussing the comments of "scientifically implausible..." in your note. We can certainly find a number of references that state the opposite along with controlled trials. Let us borrow from the wikepedia acupuncture page and put something like this in:

While homeopathy has been a subject of active scientific research since the late 20th century, its effects are not well-understood, and it remains controversial among researchers and clinicians.[ The body of evidence remains inconclusive but is active and growing. The WHO, the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), the American Medical Association (AMA) and various government reports have all studied and commented on the efficacy (or lack therof) of homeopathy. There is general agreement that homeopathy is safe when administered by well-trained practitioners, and that further research is warranted.

If you agree, I am sure we can find nice little references for the statements. If not, I wonder why you don’t fight these statements in acupuncture given that it is just as strange and implausible. Lets be professional and agree to disagree in a reasonable way.

BTW- If Einstein's work is a "refinement", then homeopathy can be a refinement as well. We are mincing words here. Dr. Polich

No comments back disagreeing with my suggestion? Perhaps we can follow the lead from acupuncture throughout the page to present a skeptical but polite way to address the issues of homeopathy. If so, how do we get the page officially changed? Dr. Polich —Preceding unsigned comment added by 70.131.107.176 (talk) 10:37, 2 July 2008 (UTC)

The analogy with acupuncture is flawed, as acupuncture has physically measurable effects. The debate over acupuncture is very different. The current theories suggested for how homeopathy might work are generally not refinements of well tested and understood scientific principles, rather they are counter to them; this is not a mincing of words nor a debate over mere semantics. There is currently no theory to explain the claimed effects of homeopathy that is consistent with scientific models and observation. I am against the changes you have suggested as they greatly misrepresent the situation with regards to homeopathy and evidence. Please get an account so that we can discuss things not directly related to the article without disrupting this page, or say hello on my talk page and we can invite others to discuss things there (that aren't directly related to the article). At the very least please sign your comments :) --SesquipedalianVerbiage (talk) 11:24, 2 July 2008 (UTC)

Talk of scientific principles is pseudoscience which was discarded in the Renaissance. Modern science is essentially empirical - it makes experiments and observations. Theories and principles are secondary and must follow these results whither they lead, whether they make sense or not. In medicine, simple mechanistic ideas do not suffice to explain many observations. For example, if you give someone an emetic in a certain way then it is found to have the opposite effect of preventing nausea. It seems that the doctor-patient relationship plays a considerable part in this and it may be that homeopathy is especially efficacious in this regard. Our lede should not be dogmatic when the matter is not fully understood. Colonel Warden (talk) 13:06, 2 July 2008 (UTC)

CW, you are partly right, but as that implies partly wrong. However, as I have said above and to you before, this is not a forum for discussion about homeopathy in general. The lead is accurate. --SesquipedalianVerbiage (talk) 13:26, 2 July 2008 (UTC)

The article concerns homeopathy in general and so we must necessarily discuss this as we decide what to say. My comments relate to the content of our lede and so are quite proper. Since your own paragraph above is of a similar nature, your stricture is impertinent and hypocritical. Since such hectoring is uncivil and the article is on probation, please desist from such disruption lest you be sanctioned. For avoidance of doubt, let me be clear that my point is that our lede should not talk of fundamental scientific principles as it does. This is an improper synthesis which does not belong here. Colonel Warden (talk) 13:50, 2 July 2008 (UTC)

I replied to your comments on the lead, and my comments about this not being a forum were directed mainly at the user without an account, and thus a talk page. I apologise if you thought I was being uncivil, that is not my intention. I was asking them to cease disruption of this page, although their comments directly related to improving the page are welcomed (as some of their comments have been). WP:TALK applies to all of us. It would be good if they got an account so they could join in more fully. Regarding your comments, I think you are right that theory follows experiment, and that theory and experiment must agree (with experiment taking primacy). However, I fail to see how this relates to the lead, as the lead is quite accurate. Homeopathy has not been shown to be effective, nor has it been shown to be a "more effective" form of placebo. The principles of homeopathy, and postulated methods of action, currently do not agree with experiment nor do they fit with established theories. They in fact appear to be contradictory to experiment and well established theories. The lead gives a summary of the scientific and medical view of homeopathy, which features in the article and is thus right and proper. I also think your call of synthesis is also incorrect, but obviously these are my opinions and the community should form a consensus about what should be in the lead. --SesquipedalianVerbiage (talk) 14:13, 2 July 2008 (UTC)

in my view i fele that the articles lead could be improved by adding information related to the homeoapthic controversy. The way the lead is writen now indicates that everyone is fuly aware of the mainstream scientific view of homeopathy. While the mainstream scientific view should have primality in the article, the cultural and alternative scientific prevalance of homeopathy should also be taken into acount. This is not so say that the lead should say that homeopathy is 100% perfect or anything, but simply to indicate that homeopathy isnt completely discredited with every single medical profession in the world. It shouldnt go into too much detail (thats what the main body of the article 0f for), but it should at least be a summary of the arguments presented re: hoemoapthys success, failure, re: placebos, et al in the main text of the article. My two scents. Smith Jones (talk) 16:02, 2 July 2008 (UTC)

Ses, you state that this discussion is about editing the text and not about the efficacy of homeopathy yet you also return to this point. Obviously, it is an important one in resolving this issue. Regarding the comparison with accupunture. Yes, it is obviously the same. The Accupunture theory is just as far fetched as homeopathy and well as their claims. You can find research that is pro and con. However, both work in some unexplained way. Beter yet, would you have put such strong language 20 years ago when there was not as much research on accupuncture? Did that change the fact that is works? Anyway, my main request would be to remove the offensive paragraph while this is being disputed. Is there an official way to do this. Who can edit the page? BTW- why does it matter if I have an official sign on ? I sign my pages so you know who I am? Dr. Polich —Preceding unsigned comment added by 70.131.107.176 (talk) 12:56, 3 July 2008 (UTC)

One reason to get an account is that you can then edit the page. It also means other editors can leave you messages or discuss things with you on your talk page. The watchlist is also useful. I'm sure there are other great reasons... (I've now left a note on your IP address page.) However, I still think the comparison to acupuncture is invalid, as acupuncture has evidence of effect whereas homeopathy doesn't (beyond placebo). Acupuncture can also fit into current medical theory, whereas homeopathy can't. Acupuncture is a usually practised as a complementary therapy with EBM, whereas homeopathy is usually an alternative to EBM, and rejects much of modern medicine. The differences between homeopathy and acupuncture, the evidence for them, general acceptance within science, and the problems they face, are vast. For example, while it is known that acupuncture has an effect (you are sticking needles in people, after all) and that this could cause the release of chemicals such as endorphins, the mystecism of meridians and pressure points is much more debatable. Before removing the paragraph you would have to build consensus for this, and as yet there is none. To build consensus, it might be best to suggest alternative wordings or changes below in a new section so people can find them easier, if you like. New discussions usually go at bottom, and are more likely to get people's attention there. --SesquipedalianVerbiage (talk) 13:28, 3 July 2008 (UTC)

Thanks for your input. I now have an account. If we need a consensus to remove it, how come we did not have one to create the paragraph? I realize that you think homeopath is quackery, but even you must admit that the wording is not consistant with other pages. Regarding acupuncture, sure you are sticking needles into the body. However, that does not at all explain the reactions that are observed. Similarly, recent studies of homeopathic remedies in water show thermodynamic changes to the water. However, the issue is that we should stick to non-inflammatory statements where there is consensus. There is no way that there will be consensus where the statements include “homeopathy does not work or there is NO scientific evidence supporting homeopath” or any other similar statements. Both of these statements are false. I agree that there are more studies that are negative than positive, but it is false to state that there are no studies. In addition, either homeopathy works or it does not. If there is a single study that clearly shows that homeopathy works then it must be possible. Clearly, drinking water would NEVER result in a positive study beyond the placebo effect. Speaking of which, one thing that homeopathy has hugely is a healing crisis, where things get worse before they get better (which may account for some of the issues with our studies). This is NEVER seen in placebo studies and it is very common in homeopathic treatment. Anyway, can you propose the nicest, least offensive language you are comfortable with? Drpolich (talk) 13:55, 3 July 2008 (UTC)

I really don't think there is a problem with the 2nd paragraph of the lead; it is verifiable from reliable sources, correct, and gives both points of view with a respectable balance. The only change I would think could be done, to address the lead only, is to contract the final sentence from "The lack of convincing scientific evidence supporting its efficacy[15] and its use of remedies without active ingredients have caused homeopathy to be regarded as pseudoscience;[16] quackery;[17][18][19] or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst."[20]" to "The lack of convincing scientific evidence supporting its efficacy[15] has caused homeopathy to be regarded as pseudoscience.[20]" and place the rest of the sentence in the appropriate place in the article. --SesquipedalianVerbiage (talk) 14:09, 3 July 2008 (UTC)

This is highly inconsistent with the reasoning ("NOT in the criticism paragraph") of removing the verifiable and reliable references to effects of highly diluted compounds in the phrase "While homeopathy advocates point to effects of compounds diluted almost out of existence[7][8]". Is the second paragraph a "criticism paragraph" (then why is it not titled as such?) or one that gives "both points of view with a respectable balance" ? Vyx (talk) 00:32, 18 July 2008 (UTC)

I didn't mean to imply that this paragraph can only have such things in it and is only to be critical, but rather than the focus of this paragraph is on scientific evaluations of homeopathy (which is what I should have said rather than criticisms). The other two paragraphs focus on summarising other areas of the article (definition and history, legality and prevalence), and not all references should go in the lead. It's much better to suggest changes to the lead, and other large changes, in a new section at the bottom of this page to get multiple input before applying your changes. I'm not sure that your references address the point of the paragraph, as these studies are not done at usual levels of homeopathic dilution (I think, I need to check). In homeopathic levels (beyond 12c, 30c is usual) it is not just diluted almost out of existence, but statistically there is not going to be any of the original substance left. They might have a place further in the paragraph as a response. As a whole, I think the lead gives both points of view (several actually) with appropriate balance, although I realise some people have problems with the 2nd paragraph. If ways such as my suggestion above and your current edit can be found that make the lead more acceptable, without diluting (!) the content and thus breaking NPOV/etc, that would be great. --SesquipedalianVerbiage (talk) 08:12, 18 July 2008 (UTC)

Apologies, I've just realised you are referring to another editor and not my comment on your talk page. I would think their reasoning is similar, but I don't know obviously. :) --SesquipedalianVerbiage (talk) 10:17, 18 July 2008 (UTC)

Ok, lets take a page from Wiki regarding psudoscience. I quote Pseudoscience also differs from protoscience. Protoscience is a term sometimes used to describe a hypothesis that has not yet been tested adequately by the scientific method, but which is otherwise consistent with existing science or which, where inconsistent, offers reasonable account of the inconsistency. It may also describe the transition from a body of practical knowledge into a scientific field.

Ultimately, whether something is pseudoscience or not has less to do with the ideas under study than the approach used to study or justify them. Acupuncture, for instance, while it involved a prescientific system, is not inherently pseudoscientific. This is because most of the claims can be tested scientifically so acupuncture can be viewed as a protoscience. Of course, a scientific investigation might fail to support the claims of acupuncture. In the presence of a number of tests that successfully falsify a particular claim, insisting that the claim is still scientifically supported becomes pseudoscience.

Based upon this definition. Homeopathy is NOT a psudoscience, just like acupuncture because it can be scientifically tested. Just because you have a references for the following statements " regarded as pseudoscience;[16] quackery;[17][18][19] or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst."[20]" does not mean that it is. I am sure I can find statements that homeopathy cures AIDS. However, it is not true. We must remove any statements like quackery, pseudoscience etc. Can you come up with something a bit more reasonable? Drpolich (talk) 14:28, 3 July 2008 (UTC)

See the archive for Homeopathy/pseudoscience discussions. I think I read that there was also an arbcom decision related to this, maybe someone can provide the references. Personally, I think the label is appropriate, as unlike acupuncture homeopathy is not consistent with accepted scientific theory, and it is well sourced. I agree that homeopaths should not be allowed to claim that they can cure disease. My proposed change above seems reasonable, and would remove the word quackery from the lead which seems to be one of the areas of contention. --SesquipedalianVerbiage (talk) 15:45, 3 July 2008 (UTC)

Fine, lets look at a page with a medicine that is even less studied than homeopathy and has less clinical information. If you look at that web page they present lots of information on the practice without calling it names like pseudoscience etc. Lets follow the practice on the Arurvedic page present inbiased information and put a comment in the bottom similar to this....

Critics object to the lack of rigorous scientific studies and clinical trials of many ayurvedic products. The National Center for Complementary and Alternative Medicine states that "most clinical trials of Ayurvedic approaches have been small, had problems with research designs, lacked appropriate control groups, or had other issues that affected how meaningful the results were."[20]

In India, research in Ayurveda is largely undertaken by the statutory body of the Central Government, the Central Council for Research in Ayurveda and Siddha (CCRAS), through a national network of research institutes.[21] A large number of non-governmental organisations are also conducting research work on different aspects of Ayurveda[22]. However, "even staunch advocates of Ayurveda like cardiologist Dr. M.S. Valiathan...admit that 'clinical studies that would satisfy the liberal criteria of WHO World Health Organisation have been alarmingly few from India, in spite of patients crowding in Ayurvedic hospitals"'.[20]

If you are fair you will have to agree that there is no way ayurveda is even less proven or believable. Their page is a fair representative on how we should proceed. 70.131.107.176 (talk) 22:34, 3 July 2008 (UTC)

wHAT DOES Ayourveda have to do with Homeoapthy? --Smith Jones (talk) 16:45, 3 July 2008 (UTC)

Come on??? answer? Smith Jones (talk) 22:51, 3 July 2008 (UTC)

Smith, it has nothing to do with anything, it's all just a WP:OR discussion to try to remove every negative qualifier from the article independently of what the sources actually say. I like specially "X is NOT pseudoscience because it can be scientifically tested". ~~Uh, yeah, sure, right, whatever you say~~. I'm not going to enter into details. Let's just say that pseudoscience is not defined by whether the subject can be scientifically tested. It's more about having proponents that say (or have said on the past, like Worlds_in_Collision) that it has a scientific basis after it has been tested with negative results or unconclusive results, or after the positive studies have been replicated with negative results. If something can not be scientifically tested, I guess that it becomes pseudoscience when proponents claim that it can be tested and start making faulty science to prove it. Also consider the usual exceptions for religious stuff, which is currently not labelled as pseudoscience on wikipedia, and for all shades of grey, and please consider that this is not a complete definition of the term.... --Enric Naval (talk) 01:41, 4 July 2008 (UTC)

Smith, sorry for not answering earlier. I have not been on in awhile. I realize that no matter how much positive research we present on homeopathy, there will be those that state that it is impossible. It is impossible for the two sides to agree. Thus, I have simply skipped this fruitless discussion and pointed out that there is less vitriolic language used in other therapies that are even less proven than homeopathy. We can choose to follow the tradition of Wikipedia as indicated by the Ayervedic page and choose to indicate that there is controversy without using offensive verbiage. Again, if you are not comfortable with this approach, I ask WHY? Why attack homeopathy and not all of the others? Drpolich (talk) 05:37, 9 July 2008 (UTC)

critics object that

I removed "critics object that" from the lead, as it appears to imply that only critics of homeopathy say that it has no scientific basis.

However, the fourth source for that sentence is an AMA report that plainly states that the efficacy of most homeopathic remedies has never been proven, and that there is some research touting efficacy for childhood dhyarrea, but that it has been criticized for several reasons and that its clinical significance has been called into question. It doesn't say anywhere that the efficacy is only put in question by critics.

As for the NHS source [1] (second lnk on the third reference), it talks about "supporters of homeopathy", but it does not talk about "critics of homeopathy". Instead, it talks about "Many medical doctors and scientists" and "some scientists", and it also makes non-attributed statements about clinical evidence and effects being caused by placebo effect (on the first paragraph)

As for the rest of sources, they appear to be several clinical studies of efficacy made by neutral parties and not by critics. --Enric Naval (talk) 11:15, 20 July 2008 (UTC)

I agree. Brunton (talk) 13:01, 20 July 2008 (UTC)

Also, the first reference is authored by Edzard Ernst, who should count more as "expert of the field" than as "critic". They talk about him on this Guardian article [2] that got added today to the article. --Enric Naval (talk) 02:58, 22 July 2008 (UTC)

Time article by Toufexis

I just found this Time article:

IS HOMEOPATHY GOOD MEDICINE? - ANASTASIA TOUFEXIS

It mentions our topic banned editor User:DanaUllman and quotes Stephen Barrett. Even though it is from 1995, it is a RS for opinions, as well as possibly for scientific sources that can be sourced directly. -- Fyslee / talk 18:57, 22 June 2008 (UTC)

Stephen Barrett is a very controversial figure. We should avoid refering to him in this article. There is an abundance of RS scientific sources with the same message that are much less controversial. MaxPont (talk) 06:11, 24 June 2008 (UTC)

Looking at his wikipedia page he doesn't look that controversial. His only critics seem to be in the communities he criticises, while he is referenced as a good source by many leading mainstream science publications. I also think Time is a good source, so I don't see why this article can't be used. However, whether it is used depends on what it will be used for. Has anyone proposed any additions based on this article? I notice it's used on Dana Ullman's page to justify some peacockery. --SesquipedalianVerbiage (talk) 12:01, 24 June 2008 (UTC)

The article could be included if we need yet another reference, which I doubt. But Barrett is a red flag for everyone who is critical of conventional medicine (look at the talk page archive on his article). Barrett has a fan club of followers here on Wikipedia that want to promote him wherever they can. There is no need to stir up more controversy than necessary here. We should rely on credible scientific sources in this article. Not a campaigner without scientific credentials. If we include the article I recommend that Barrett is not mentioned. Mentioning Barret will actually make this article less credible. MaxPont (talk) 15:31, 24 June 2008 (UTC)

Agree with MaxPont. And if it seems that Barrett is not that controversial, it is because of the whitewashing which had occurred on his article for the better part of two years (and seemingly still continues!). -- Levine2112 ^discuss 20:58, 24 June 2008 (UTC)

It probably isn't a good idea to spread that argument to this page. --SesquipedalianVerbiage (talk) 21:03, 24 June 2008 (UTC)

All the more reason to leave it out of the article. ;-) -- Levine2112 ^discuss 21:10, 24 June 2008 (UTC)

If it's a good addition, it should go in, with qualification as necessary. However, no addition has been suggested - it's just been brought here as an interesting source. --SesquipedalianVerbiage (talk) 21:14, 24 June 2008 (UTC)

Yes, "it's just been brought here as an interesting source," but it sure has brought out the usual and totally invalid arguments against using Barrett as a source: he's controversial. He has enemies who will do almost anything to keep his very notable opinions out of articles, no matter how well sourced; and there are editors who think that well-sourced, controversial opinions from notable individuals who are generally recognized by the mainstream as experts on the quackery aspects of some subjects happens to be the stuff which makes Wikipedia richer and which are not forbidden by any policy here. "I don't like it" seems to be the modus operandi for not quoting him. It's a pretty despicable agenda. Hmmm... Such unwikipedian attitudes need to be douched with a healthy dose of NPOV for a few decades. -- Fyslee / talk 06:15, 2 July 2008 (UTC)

Please declare your interest. Colonel Warden (talk) 06:43, 2 July 2008 (UTC)

None. See ArbCom case. Will discuss further on my talk page if you wish, but not here as your remark is off-topic and a violation of both NPA and TAlK. -- Fyslee / talk 05:21, 3 July 2008 (UTC)

Its better to use sources that eventually link to primary sources for those who wish to delve further. The Barrett article on aromatherapy, for example, did not cite any Pubmed summaries of the use of essential oils in mood alteration, wound care or antibacterial mouthrinses.Cayte (talk) 00:46, 6 July 2008 (UTC)

An idea to consolidate & trim...

I think the current article is a bit heavy on the mathematical arguments regarding the high dilutions. This contributes to the large size of the page and, no doubt, to the feelings of the pro-homeopathy side of an overly skeptical tone. I'd suggest a potentially simple change could help alleviate this:

Given that the swimming pool example, its large footnote, and and the dilution calculation is roughly 5kb, perhaps it would be best to move it into a "proof page" or appendix of sorts? I'm thinking of the type of thing they put in textbooks wherein a claim supported by complex evidence or a mathematical proof is simply cited in the general text as "see Appendix A" and Appendix A has the gory details and relevant citations. We could create a subpage, Homeopathy/Dilutions (or similar), that serves as an appendix, and leave simplified claims of "__ dilution is equivalent to __ ridiculously huge volume^{[reflink to appendix]}". This would allow us to maintain even the exact current text, but reduce the main article's size and (in my opinion) overload of mathematical gymnastics.

Any thoughts? — Scientizzle 19:35, 3 June 2008 (UTC)

How about leaving a summary in, and creating a subpage called homeopathy and dilution (like the homeopathy and allopathy page). This could cover succussion from the homeopaths perspective and have a serial/volume-to-volume dilution and discussion of the arguments (hormesis, Arndt-Schulz rule) and include the analogies + discussions that are too wordy to go in here. There is probably enough for a whole article. There has also been talk of a "Scientific criticisms of homeopathy" article, which could reduce the perceived non-neutrality (I think this article is more or less correct) by taking the bulk of the criticisms and science elsewhere, but leaving good summaries that point to the new articles. The main page could just have a few top quality references, while the bulk of the scientific evidence is moved (but still referenced). Obviously, the lead should still contain criticism (in about the same proportion in my opinion). But the homeopathy and dilutions page might be a good start. I hope I've not misunderstood your intention - I just think it's such an interesting old chestnut that always comes up in homeopathy discussions, and hence deserves it's own page (more than the homeopathic MM does at the moment!) SesquipedalianVerbiage (talk)

Or Homeopathic succusion and dilution maybe. —Preceding unsigned comment added by SesquipedalianVerbiage (talk • contribs) 21:20, 3 June 2008 (UTC)

My personal opinion is that a separate "Scientific criticisms of homeopathy" article is currently unnecessary, and that general editing for clarity and brevity is currently the best option. My "appendix" proposal wouldn't (technically) create a new article, but allow finer detail of the moderately confusing and complex mathematical evaluations to exist (and improve) as a subordinate reference subpage, essentially. I'd envision something like this:

blah blah Homeopathic preparations often involve such extensive dilution that __ dilution is equivalent to __, and __ is equivalent to __.^[α]
[...]
References
[...]
α Please see Homeopathy/Dilutions for detailed explanations regarding the dilution calculations and their example equivalents.

This could replace a lot of the text in Homeopathy#Dilution_and_succussion without losing any content. I think it would be best if limited strictly to the mathematical sources and examples. — Scientizzle 22:11, 3 June 2008 (UTC)

Thanks for starting this discussion. What I don't understand is why that much material needs to be preserved in the first place. It's excessively repetitive (we have counted the "wow, that diluted!" metaphors above, so I won't do it here), and it only stresses the general prejudice that all homeopathic remedies are diluted to that point. E.g. the only remedy mentioned in that section is oscillococcinum 200C, which incorrectly (at least for Germany; especially the US situation may be different, of course) suggests that it is typical in the sense that most homeopathic remedies are diluted beyond the Avogadro limit and therefore obviously harmless. It looks as if 1X only occurs in the table for systematic reason, which is just not true. But of course, if we also discuss remedies like Arnica 1X, then we may have to explain that of course the homeopathy exception in pharmaceutical regulations (no clinical studies needed, no proof of efficacy needed) only applies to "high potencies", and that in most countries you can expect that efficacy of "low potency" remedies has been tested.

Currently what our readers will remember in the long term is 1) all reasonable scientists agree that homeopathy is crap, and 2) all homeopathic remedies are harmless because they are so diluted. The typical esoterically oriented reader would happily take Arsenicum album 1X after reading this article. --Hans Adler (talk) 07:21, 4 June 2008 (UTC)

Are you saying that you know of studies using low potency remedies that have demonstrated clinical efficacy when applied according to homeopathic principles? Das ist mir neu! --Art Carlson (talk) 07:50, 4 June 2008 (UTC)

I confess that I am not sure about the exact details. But e.g. I am using a German homeopathic hayfever remedy which contains substances in 3X and 4X dilution and is sold with a clear indication of purpose, two reasons for it not to fall under the homeopathy exception. I am not 100% sure they didn't use another type of exception for this, but I will try to find out in the next couple of days. (I had once researched the regulations for Wikipedia, but I don't have the time to re-read them now.) --Hans Adler (talk) 08:02, 4 June 2008 (UTC)

The UK recently (2006) introduced a new scheme ("The National Rules Scheme") for homoeopathic medicines which allows them to give indications of purpose (limited to minor conditions, which would include hayfever) without having undergone clinical trials, as long as the manufacturer provides data relating to their safety. This allows low potency remedies to be marketed without proving efficacy. It was implementing provisions of an EU directive (Directive 2001/83/EC), so it's possible that a similar scheme has been introduced in Germany. See the MHRA's Homoeopathic medicines page. Brunton (talk) 16:17, 4 June 2008 (UTC)

Thanks for the clear pointer. [3] I wasn't going to look it up so soon, but you made it very easy. The homeopathy exception (Article 14) clearly doesn't apply: "Only homeopathic medicinal products which satisfy all of the following conditions may be subject to a special, simplified registration procedure: […] - no specific therapeutic indication appears on the labelling of the medicinal product or in any information relating thereto" (and it also requires a dilution of 4X or more). But they may be using the exception for traditional herbal medicinal products (Article 16a), with conditions including: "in particular the product proves not to be harmful in the specified conditions of use and the pharmacological effects or efficacy of the medicinal product are plausible on the basis of long-standing use and experience". In some member states the plausibility requirement probably excludes higher potencies. --Hans Adler (talk) 18:20, 4 June 2008 (UTC)

Arsenicum album 1X? So it's 10% arsenic?! Good way to get arsenic poisoning, that. Shoemaker's Holiday (talk) 16:50, 4 June 2008 (UTC)

I am quite sure it's not being marketed. :-) Not too surprisingly, even heroic medicine used it (externally) in a more diluted form, about 3X. [4] --Hans Adler (talk) 18:20, 4 June 2008 (UTC)

Getting back on topic, I think this is a good idea but that there is enough information, and it is notable and interesting enough, to go in its own daughter article. With an adequate summary (including some quotes/discussion) left here, but with the mathematics and bulk of the analysis moved to it's own page. SesquipedalianVerbiage (talk) —Preceding comment was added at 16:44, 4 June 2008 (UTC)

I'm against producing new articles when we're barely able to maintain the current number. Shoemaker's Holiday (talk) 16:50, 4 June 2008 (UTC)

How's that? The prevalence one is a bit messy, but the preparations, homeopathy and allopathy, water memory, serial dilutions and this page aren't bad. SesquipedalianVerbiage (talk) —Preceding comment was added at 17:43, 4 June 2008 (UTC)

Today while going through WP NPOV i noyice this external link [5], i think active editors of this article must at least once go through the article at this link, so that scientic attitude is not sacrificed in the name of neutralityHallenrm (talk) 17:46, 4 June 2008 (UTC)

that article is at best slanted or at most only indicativa of the authors own opinion. while it makes some good points it is nto the law of wikipedia or the Interne tand there is no real obligation to stick to anything under than the actual ypollicy of WP:NPOV as outlined on the website itselfe intead of in external link ourticles. thank youf or your contributiaon. Smith Jones (talk) 00:03, 8 June 2008 (UTC)

Why not move the dilution section to the article Serial dilution. MaxPont (talk) 05:35, 10 June 2008 (UTC)

Or, go back to the original subpage idea, and then we can decide whether to spin it off properly (into own article), or move it to another article (serial dilution), leave it as a subpage, or put it back in the article. A summary should, of course, remain. --SesquipedalianVerbiage (talk) 09:26, 19 June 2008 (UTC)

Feedback requested

I went ahead and enacted my vision above: see Homeopathy/Appendix: Dilutions, the new site of the info moved from the current version.

I feel this set of edits reduces the bulk of the main article, consolidates dilution information, and pares down some of the dilution-based criticism that has bothered people. What are your opinions? Thanks, — Scientizzle 17:51, 26 June 2008 (UTC)

Wooot, that new page looks very good. I approve of this new page. However, the location is probably breaking Wikipedia:Manual of Style (titles), it should probably be moved to something like Homeopathic dilution or something (it can be moved later to a better name depending of how its content evolves). Also, under "Dilution and succussion", you should separate part of the content on its own subsection called "mathetical basis" and add {{main|Homeopathic dilution}} under it, to make the link to the article clearer. --Enric Naval (talk) 18:16, 26 June 2008 (UTC)

I agree that this deserves to be an article. It'll be more technical than others, but since this is the science behind homeopathic dilutions I see no problem with that - like other science articles. As the person who created the Homeopathic dilutions redirect, I'd support the move there. Verbal chat 17:10, 26 July 2008 (UTC)

Systematic review of homeopathy representation in CAM journals, possible bias

I've been interested in how CAM views homeopathy (whether there is a faction within the group which is highly skeptical). The review suggests that much of CAM is pretty sympathetic to homeopathy. Minor corrections here. II | (t - c) 22:34, 22 July 2008 (UTC)

The source is a useful one but you have not addressed its conclusions which were:

A considerable difference exists between the number of clinical trials showing positive results published in CAM journals compared with traditional journals. We found only 30% of those articles published in CAM journals presented negative findings, whereas over twice that amount were published in traditional journals. These results suggest a publication bias against homeopathy exists in mainstream journals. Conversely, the same type of publication bias does not appear to exist between review and meta-analysis articles published in the two types of journals.

I have presented this matter in a separate sub-section which paraphrases these conclusions. Colonel Warden (talk) 09:26, 26 July 2008 (UTC)

I reverted your changes as they represented a clear bias and misrepresented the reports. I also put back the pseudo-science box as it's removal has not been discussed. Verbal chat 09:36, 26 July 2008 (UTC)

I report the conclusions of the source verbatim above. Please explain how I misrepresented them. My strong impression is that User:ImperfectlyInformed distorted the source in his version and my effort was an attempt to be closer to the source. I shall now revert to take out his version too while we decide how the matter is best presented. The pseudoscience sidebar will have to be taken separately. Colonel Warden (talk) 09:55, 26 July 2008 (UTC)

We need to keep a summary style. This page is wordy enough as it is. This paper should not get more than a sentence. However, I guess I did misrepresent the paper. For some reason I skipped over the abstract and looked at the body, and I thought these guys would conclude that a bias exists in CAM journals, especially when only one CAM review mentions the scientific implausibility. But I guess I expected more from this review, and they do conclude that "these results suggest a publication bias against homeopathy exists in mainstream journals". Obviously, it swings both ways -- a bias in CAM journals -- but the paper doesn't note that possibility. II | (t - c) 10:16, 26 July 2008 (UTC)

Actually... . I expanded the text [6] (diff from a sandbox to see the changes better). It was very difficult not to misrepresent it with only one sentence. However, I see that this section already has analysis of publication bias, so it would need to be integrated better with the rest of the text. --Enric Naval (talk) 16:59, 26 July 2008 (UTC)

Pseudoscience template

I agree that the pseudoscience sidebar should remain unless a consensus is built to remove it.Verbal chat 10:01, 26 July 2008 (UTC)

It seems a pointless excresence to me, adding no value to the reader and just adding to the general clutter. This article is far too large, being 95K, and so we must shed some of the bric-a-brac like this. Colonel Warden (talk) 10:07, 26 July 2008 (UTC)

It could perhaps do with trimming but should remain. As the list of proponents and organisations is repeated at the bottom, I suggest replacing with "see below" or some better wording. Verbal chat 10:24, 26 July 2008 (UTC)

It is a template and so cannot be trimmed here. It seems that all its content is repeated elsewhere in the article and so it is redundant. Colonel Warden (talk) 11:07, 26 July 2008 (UTC)

Infoboxes are supposed to summarize info already present on the article...... --Enric Naval (talk) 16:16, 26 July 2008 (UTC)

It should remain. II | (t - c) 10:25, 26 July 2008 (UTC)

Because? Colonel Warden (talk) 11:07, 26 July 2008 (UTC)

Must of the article is still badly sourced, and no argument has been presented that the field is not considered pseudoscience. If the article needs to be trimmed, the metastudies which analyze non-peer-reviewed studies should be dropped, as meta-analysis is only as good as the data presented in the analyzed studies. — Arthur Rubin (talk) 15:53, 26 July 2008 (UTC)

Tuatopathy and Bach Flower Remedies subsection

Could be removed or substantially trimmed, and a link to their main articles added instead. This would reduce some of the apparent clutter. Verbal chat 10:32, 26 July 2008 (UTC)

I agree - the See also section is the place for related topics. Colonel Warden (talk) 11:09, 26 July 2008 (UTC)

I'll have ago at this now (and apologies for messing up WoodenBuddha's edits). Verbal chat 12:10, 27 July 2008 (UTC)

I've removed the tautopathy section, but the flower remedy section actually seems quite relevant and hard to condense at all. Verbal chat 12:22, 27 July 2008 (UTC)

Problem with Dennis study citation

For reference 11, a study from Brown and Ennis, Springer says that the doi is 1023-3830/01/02S47-02 [7], but the doi naming authority says that it doesn't exist [8]. Anyone can find the correct doi for this study? --Enric Naval (talk) 13:32, 27 July 2008 (UTC)

Care-augmented placebo effect

I can't add to the article as it's 'semi-protected'. But for anyone who can you might want to note a theory proposed in this review that because it has been shown that homeopaths spend more time with their patients than doctors, this added level of care "likely enhances expectancy and placebo effects." Sounds plausible to me. 96.241.126.252 (talk) 21:47, 27 July 2008 (UTC)

Placebo and scientific plausibility

I'm proposing a modification in "Homeopathy is scientifically implausible" to "Homeopathy beyond placebo effect is scientifically implausible". The rationale is that if the proponents of homeopathy accepted that it is just an elaborate use of placebos, then there would be no disputes over its scientific plausability. In other words: homeopathy is scientific implausible only if it claims effects beyond placebo. (Note 1: please notice the "if" above; it's just a hypothetical argument to show the contradiction in the original statement. Please refrain from disputing whether homeopathy is just placebo or not. Note 2: placebos have their valor, i.e., placebo is much better a therapy than nothing at all.) Fgnievinski (talk) 16:14, 20 May 2008 (UTC)

I agree with this, since it fits perfectly with the later quote of "placebo therapy at best and quackery at worst." Tim Vickers (talk) 16:18, 20 May 2008 (UTC)

Ditto for me. It's a necessary caveat. It may help to streamline the scientific consensus paragraph to combine the placebo effect clauses and separate them from the claims of violating the basics of chemistry & whatnot. — Scientizzle 18:49, 20 May 2008 (UTC)

Hmmm, to modify my previous statement...Adding any form of "beyond placebo effect" to the above sentence actually makes the paragraph more redundant, as the first sentence states "Claims for efficacy of homeopathic treatment beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence". Clearly the lead is a bit jumbled already... — Scientizzle 21:03, 20 May 2008 (UTC)

Could you make it "Homeopathy, beyond placebo effect, is scientifically implausible" or "Any beneficial effects of homeopathic preparations, beyond possible placebo effects, are scientifically implausible", and wikilink if needed. Also, the grammar in general is a bit of a mess. And the lead is a bit long - partly due to all the unneeded refs for things that are referenced later. --78.54.120.62 (talk) 18:52, 20 May 2008 (UTC)

I tried something that may help with the clarity of that paragraph. Feel free to improve or revert. — Scientizzle 22:12, 20 May 2008 (UTC)

Just for the record, OrangeMarlin reverted the essence of Scientizzle's edit, removing "greater than placebo" in the sentence "claims that these treatments have a pharmacological effect greater than placebo are considered scientifically implausible" [9]. Fgnievinski (talk) 06:47, 25 May 2008 (UTC)

I disagree. Placebo effect may be as scientifically possible as homeopathy, meaning, not at all. Placebo effect implies that there might be some causative value, even psychological. There's no scientific proof for this. It is clear that a random subsection of any population will either get worse or better with a non-therapeutic action, and by random probability the placebo effect just happens. Making it appear that homeopathic potions actually have any beneficial effect, even psychological, is not supported by any evidence whatsoever.^[1] OrangeMarlin ^{Talk• Contributions} 21:08, 20 May 2008 (UTC)

Correct me if I am wrong, but it seems that your contention concerns the placebo effect itself, not whether homeopathy is at least as good as placebo, which is the point under discussion. While such contention is conceivable, it pertains to the article about placebo, not homeopathy. Regarding the actual point under discussion, it seems to me that there is enough evidence indicating that, indeed, homeopathy is at least as good as placebo. I might even dare to say that there is consensus in the body of original research regarding that position. (For references, please see each and every occurrence of the word "placebo" under homeopathy.) Fgnievinski (talk) 00:11, 21 May 2008 (UTC)

Clearly, homeopathic lotions and potions lack any effect whatsoever. Even stating that it has a placebo effect, which has no scientific backing, is giving it medical credit, where it deserves none. BTW, there is no "consensus" in science. That's a canard that has no real meaning. Scientists do not sit around a room, debate for a few hours, then build a hypothesis and theory. Let's stick to the current statement. It doesn't do anything. OrangeMarlin ^{Talk• Contributions} 00:38, 21 May 2008 (UTC)

By consensus I meant that there is not even a single piece of original research denying placebo effects to homeopathy. Please prove me wrong indicating any contradictory reference. Fgnievinski (talk) 01:03, 21 May 2008 (UTC)

It is clear that you have an opinion about the value of homeopathy ("[it] deserves [no medical credit]"). You're entitled to. I might even share it. But it seems that you are further proposing that such opinion should be pushed down to the reader. I disagree with that; wouldn't that violate NPOV? Fgnievinski (talk) 01:03, 21 May 2008 (UTC)

There is no controversy in medical science that the placebo effect is for real. There are tons of studies to show that patients respond in a positive way to an empathic practitioner, a friendly atmosphere and positive suggestions (e.g. I am a doctor, I have authority, I am here to listen to your problems, I know that this drug will make you much better"). The ubiquitous placebo effect is the main reason to use the expensive double-blind studies. MaxPont (talk) 06:26, 21 May 2008 (UTC)

I think we are getting confused here about what scientific implausibility refers to! It is the theory behind the practice of homeopathy which is biologically, chemically and scientifically implausible. There is nothing about placebo in the founding theoretical hypothesis of homeopathy as far as I know. When we talk about placebo effect we are refering to the experimental results of real world testing. To say that placebo effect is scientifically implausible is of course untrue as there are plausible psychological theories to explain this effect. To say that "Homeopathy beyond placebo effect is scientifically implausible" is a mixed metaphor so to speak. The theory behind homeopathy is scientifically implausible. The theory behind the placebo effect is very scientifically plausible.--Kenneth Cooke (talk) 23:46, 20 May 2008 (UTC)

I couldn't agree more with your conclusions! But it's not clear to me whether you agree or disagree with the proposal -- it seems you'd be in favor of a third option, is that right? If so, how would it be? Fgnievinski (talk) 00:31, 21 May 2008 (UTC)

I disagree with the proposal since it mixes together two separate issues which should be kept distinct. You might say...The hypothesis forming the foundation of homeopathy lacks scientific plausibility. However homeopathy is claimed to provide benefit through the placebo effect. However I would even then argue that even the possible placebo effect benefit is not enough to out weigh the harm that homeopathy does to the overall health of a community... see below.--Kenneth Cooke (talk) 05:13, 21 May 2008 (UTC)

Let me try to re-state my point in yet other words: homeopathy is no worse than placebo. Does anybody dispute that? If not, then we should make the proposed caveat under the original statement. The rationale is that placebo might be significantly superior a therapy than nothing at all, and that denying even that slight benefit to homeopathy wouldn't be NPOV.Fgnievinski (talk) 00:31, 21 May 2008 (UTC)

Homoeopathic remedies are a bit more expensive than standard placebos, but are no better or worse than regular sugar pills, since that is what they are. Another alternative is to say "The ideas and claims of homoeopathy are scientifically implausible." Tim Vickers (talk) 01:07, 21 May 2008 (UTC)

I would agree with the similar statement "the ideas of homeopathy (meaning the theory about how it works) are scientific implausible" provided that we make the caveat "but its results (and for that matter, of any placebo treatment) are plausible". I hope I'm not stretching the point here -- I'm trying to be fair. Fgnievinski (talk) 01:18, 21 May 2008 (UTC)

I'm afraid I might have stretched the point a bit too far at this time. I'm taking it back, to avoid it attracting undue attention, in detriment of my other comments above, which I still hold. Fgnievinski (talk) 01:39, 21 May 2008 (UTC)

Homeopathy can be significantly worse than placebo. First example... The substitution of homeopathic vaccines for the real thing can and does result in signifficent avoidable illness and sometimes permanent disability or death. Second... Much needed medical treatment and diagnosis can be delayed while homeopathic treatment is being given, particularly if the homeopath is not medically trained. We are dealing with peoples health and lives here, not some life style choice.--Kenneth Cooke (talk) 05:13, 21 May 2008 (UTC)

I consider that Kenneth Cooke made a significant contribution to clarify the issue. I agree with his distinction about the scientific plausibility of the hypothetical mechanism of action versus that of claimed results of homeopathy. I also share his worries about the harm that homeopathy (and any placebo treatment, for that matter) can have when it denies otherwise necessary treatment.
Yet I think that to be neutral we must tell the whole story, just like we are doing here in the discussion page. May I therefore suggest something along these lines:

On one hand, the claimed mechanism of action for homeopathy lacks any scientific plausibility. On the other hand, the claimed benefits of homeopathy, as long as admissible under the placebo effect, are still scientific possible. Of course, beyond placebo, extraordinary claims require extraordinary evidence, which homeopathy fails to provide.

Please notice the usage of the word "scientific"; as it tends to give such strong credibility to any expression that it is attached to, I'm using it to support both positions (provided its usage is not untrue, of course).
My motivation is that the current version of the article gives the impression that homeopathy is a completely useless rubbish; assuming good faith on what homeopaths report, I don't want to deny the possibility of it being a sometimes useful placebo treatment (think of hypochondriacs). It's unfortunate that homeopaths themselves tend to make extraordinary claims regarding its mechanism of action (shooting themselves in their feet, in my opinion) and sometimes regarding its benefits beyond placebo (e.g., malaria), which is criminal in my opinion. Fgnievinski (talk) 07:08, 25 May 2008 (UTC)

It kind of has to be "scientifically implausible", a naked implausible would be very hard to support. As for your objection because it might be useful as placebo, find a few reliable sources saying that and we'll talk about homeopathy as useful placebo. I don't think it'll make the homeopathy supporters very happy, though. Shoemaker's Holiday (talk) 20:36, 30 May 2008 (UTC)

Regarding the qualifier "scientific": I was concerned that we'd be quick to use it to attack homeopathy, but reluctant to use it to support homeopathy (provided that support position is not untrue, of course). Fgnievinski (talk) 01:18, 31 May 2008 (UTC)

You are asking for reliable sources stating that homeopathy might be useful as placebo; right in front of the article, in its lead, we have it very very clear: "in the words of a 1998 medical review, '[homeopathy is] placebo therapy at best and quackery at worst.'"
Now I revert your question: show me reliable sources denying homeopathy as placebo. Because that's what the current version of the article is doing: it's giving the impression that "homeopathy is quackery, period." Fgnievinski (talk) 01:18, 31 May 2008 (UTC)

WP:NPOV/FAQ#Pseudoscience. We call it like science sees 'em. We also spend a lot of time detailing the proponents' views, but the general view, with the Lancet and Nature editorial boards coming out and saying so, is that it's at best very shaky, and cannot work better than placebo without rewriting most of science. Shoemaker's Holiday (talk) 02:27, 31 May 2008 (UTC)

You're saying that (i) representative science journals affirm that homeopathy cannot work better than placebo, which I agree. But you're also saying that (ii) the current article reflects that scientific view, which is the whole and only point of my contention.
To restate it once again: the article should imply "Admittedly, homeopathy can be as good as placebo (which is not insignificant)."; as of now, the article is implying "Homeopathy has no value at all, not even placebo." Fgnievinski (talk) 03:49, 31 May 2008 (UTC)

Placebo and scientific plausibility, continuation

I think it should be stated in the article that the effects of exposure to a homeopathic preparation are in accordance with those expected from exposure to a placebo. However, I don't think it should be worded in any way which puts a positive spin on this angle. The placebo effect is the expected background effect which would be observed if any population were given any inactive substance and told that it was a powerful remedy. The effect can be separated out as unrelated to the actual substance administered, meaning that the make-up of the placebo has no effect on whether or not it is perceived to help. The fact that homeopathy is practiced suggests that it is claiming some benefit beyond placebo, that the specific substances which are diluted are potent irrespective of the placebo effect. What is the point of the diluting and shaking if the final product is no better than tap water? The wording should clearly reflect that homeopathy is implausible, that the mechanisms of action offered thus far to explain how it would work if it did work are implausible, and that any perceived activity has been shown to be the same as that observed after administration of any inactive substance (i.e. the placebo effect). Suggesting that a homeopathic preparation somehow evokes the placebo effect is misleading, as the effect can not be shown to to be dependent on the nature of the placebo itself. It occurs in the mind of the patient (best current theory), not through any pharmacological response. Perhaps:

Perceived positive effects after administration of homeopathic preparations have been shown to be no more prevalent than those expected from any other placebo and can not be attributed to any idiosyncratic properties of the preparation itself.'

I'm certain the appropriate references are already in the article.

Puddin'head Wilson (talk) 15:11, 5 June 2008 (UTC)

I wouldn't include the words "any other": not all placebos are equal, with those involving a greater apparent intervention tending to produce a larger effect. The homoeopathic consultation process, which involves the patient and homoeopath talking about the patient's health, lifestyle etc. generally for over half an hour (cf. a GP spending an average of about 8 minutes with their patients) makes homoeopathy quite an effective placebo. Brunton (talk) 07:26, 6 June 2008 (UTC)

I think you are missing the point of what the placebo effect is. Indeed, the consultation and talking to the patient is all part of the process. But after that consultation, the administration of any substance, even tap water, will have the same effect as long as the patient thinks they are getting a powerful medicine. For most people, the simple notion of speaking with a doctor is suggestive enough to bring about the placebo effect, regardless of the duration and depth of the consultation. The big problem is this: who do you want administering your placebo? Someone who has the training and insight to determine if there is any better treatment which will have a real and needed effect, or someone who's sole goal is to get you to take a placebo regardless of whether or not they actually have any idea of what is wrong with you? Based on the evidence already cited in the article, I think it is imperative that the article be clear on the fact that homeopathic preparations have no benefit beyond any other placebo. However, since every imaginable substance has not been tested as a placebo, this wording may be unwarranted. Any other thoughts on this?Puddin'head Wilson (talk) 14:49, 6 June 2008 (UTC)

Let us also look at the limitations of the placego effect. It does not apply to infants, children or animals who can obviously not "think they will get better and therefore get better". Homeopathy works fine on all of the above. In addition, we have to constantly worry about healing crisis where the person gets worse before they are better. This does not show up in the placebo effect. Finally, placebo effects are typically very short lived, and homeopathic effects are long term. Sometimes I think I should take 50 of my Eczema patients who I know a too strong remedy will make the eczema return and demonstrate that this is not imaginary. Would you agree that if a 10 -400 concentration caused any change to anyone, you would need to question your belief system? Sadly, even if I could do it with minimal discomfort to the kids, the headlines would read "Homeopathy causes Eczema" never paying attention to the fact that the exact same remedy was used to cure the patient and that they were even better after the healing crisis. Anyway, if homeopathy were imaginary then why would we make up the healing crisis, and spend 2 hours asking every question under the sun so we can give them water? Also, if the healing of my patients is placbo, then I am in the wrong business. I think a megachurch would be way better. Drpolich (talk) 14:18, 3 July 2008 (UTC)

Studies have shown that the placebo effect can apply to children, babies, and animals. Do you have clinical evidence for the existence of the healing crisis? I'd appreciate sources for this and for your claim that homeopathic effects are better/longer lasting than placebo effects/spontaneous remission/etc. I'm sure that you practice homeopathy because you believe it works :-) --SesquipedalianVerbiage (talk) 14:33, 3 July 2008 (UTC)

"Mummy will kiss it better" is probably the original placebo. In addition, babies and animals who are unaware that they have been given a remedy are also unable to report an improvement in their condition. Any report of improvement will be made by the parent or owner, who is well aware that a remedy has been given. Brunton (talk) 17:02, 3 July 2008 (UTC)

A "healing crisis" or "aggravation" can also be a placebo effect if it is an expected result. We tend to see what we're looking for. If the patient thinks a healing crisis or aggravation is agood sign, then the placebo effect certainly comes into play. If the patient does not know about the idea of a healing crisis, it will be the homoeopath, who is expecting one as a possible (and positive) result, who interprets the patient as undergoing a healing crisis. See also nocebo. Brunton (talk) 17:57, 3 July 2008 (UTC)

Please explain to me how a 6 month old child's eczema is going to get better with placbo? A 6 month old is not able to have any idea that they are treated. I would love to see your reference that they are better with placebo. Look at the photos at http://www.dupagehomeopathic.com/homeopathic_photographs.html and tell me how it could be placebo. Regarding the healing crisis, it is documented tons in homeopathic literature. . There are numerous reported clinical cases and as a practitioner I worry about it all the time, particularly in skin ailments. If I am not careful, I can use impossibly low concentrations to cause eczema to come out all over the body. Regarding the long lasting, if you get the remedy right then the ailment will be gone completely. In placebo, the ailment typically returns after a few weeks. I am not sure of the reference, but I have an article on it I got years ago. Yes, I agree that the research is lacking. However, that does not mean that it does not work. What is really lacking is the money to do good research. I teach homeopathy at a university and because of my engineering background I constantly think of awesome experiments. However, there is no money. You can’t make any money on homeopathic remedies, so no one wants to spend the money to research it. Drpolich (talk) 05:53, 9 July 2008 (UTC)

The placebo effect is just one cause that anecdotes fail to control for. You also need to account for regression to the mean in chronic conditions, spontaneous recovery etc.

As for the suggestion that "you can't make money on homeopathic remedies", I'm sure this will come as a great surprise to Boiron. Brunton (talk) 06:53, 9 July 2008 (UTC)

The placebo effect can cause the observers to feel there is an improvement when all that is happening is the usually cyclic nature of eczema. The placebo effect can cause observers to ascribe improvements that are from other cause (such as the change of diet you talk about) to the placebo, and also spontaneous remission (which is common in eczema, especially in babies) to be ascribed to the placebo. There are lots of homeopathic manufactures and clinics that have a lot of money, can't they fund your research? Homeopathy is a billion dollar industry, there seems to be plenty of money in it. Maybe you should write up your proposals and submit them to "Homeopathy" or Dr Ben Goldacre. There is no evidence for the healing crisis - it is a mechanism for explaining why the placebo doesn't work while nature takes it's course. And remember, it gets worse before it gets better. Therefore, I think your arguments against the article are incorrect. --SesquipedalianVerbiage (talk) 06:48, 9 July 2008 (UTC)

The idea of a "healing crisis" is not unique to homoeopathy BTW, but seems to have been common in 18th/early 19th century systems of medicine, including the "orthodox" medicine of the time. Brunton (talk) 09:51, 9 July 2008 (UTC)

We are getting off topic, but I recently treated a patient who had swelling on the spinal cord. The steroids cost thousands of dollers and the homeopathic remedy $5. There is no comparison on the price. Yes Boiron makes money, but you can't charge much over the manufacturing cost. Thus, there is significantly less money to conduct extensive research. BTW- I know you won't believe this, but the patient thought it might be the steroids and not the remedy. I wondered too so I said "Lets, figure it out. Stop the remedy and we will see" The remedy was stopped and within 24 hours the pain came back.

Regarding the spontanious remission, it is possible, but not probable that each time a remedy is taken the healing gets better. You can belive that there is some sort of miraculous cure, but what is more probable? Did you even look at the photos? Do skulls reform spontaniously? Doubtful.

There are laws, extensive proceedures required for homeopathy and a significant amount of information indicating that it works. Homeopathy does not lend itself to Western style tests because of the need for individulization and the healing crisis (which dates back 200 yrs). Consensus is not possible, thus we should either delete the whole page or try to be reasonable like other "unusual" treatment pages have managed controversal subjects. Drpolich (talk) 16:23, 9 July 2008 (UTC)

The singular of data is datum, not anecdote. Drpolich, and everyone else, please remember that talkpages are not for discussion about the subject, but about the article. If anyone has a concrete proposal (deletion of the whole page is not one of them) for improving this article under the direction of Wikipedia policies and guideline, lay it out for real discussion or move along. — Scientizzle 16:33, 9 July 2008 (UTC)

The healing crisis appears in numerous sources. Our article seems to say nothing about this and so an addition seems appropriate. I may add something myself when I get a moment. Colonel Warden (talk) 16:51, 9 July 2008 (U

I apologize for going off topic. I don’t think that we will get consensus here and there are people who will not follow the polite comments that are typical of the Wikipedia regulations similar to what is found in web pages on unusual treatments like ayurvedic medicine. I will never agree to a page that includes pseudoscience and quackery. Thus I would like to gather those that are reasonable and suggest that we make a whole new page on homeopathy and add it under some title like homeopathy-balanced information. Those who want to name call can have this page. I don’t think it is worth discussing anymore under this page. If anyone is interested please let me know. We need to have a reasonable, non-inflammatory page out there. Drpolich (talk) 19:07, 9 July 2008 (UTC)

What you are proposing is a variant on the POV Fork - a variant that is very much against Wikipedia policy. Sarcasticidealist (talk) 19:22, 9 July 2008 (UTC)

However, no more than the rude words used in the current topic. Drpolich (talk) 23:25, 9 July 2008 (UTC)

Are you referring to "pseudoscience" and "quackery"? Given the extensive sourcing of those terms to scientific journals, I don't see any violation of Wikipedia policy. Sarcasticidealist (talk) 02:48, 10 July 2008 (UTC)

Your claims are ridiculous. One of the references under pseudoscience lumped all alternative medicine along with homeopathy as pseudoscience. Plus, the article references pertained to someone's opinion, with NO scientific backup. . These statements need to be removed. The statments are misleading and rude. It is clear to me that some people in this discussion are not reasonable. Why can't we remove the offensive statements until this issue is resolved?Drpolich (talk) 21:13, 12 July 2008 (UTC)

Please don't attack other editors, and remember to Assume Good Faith (WP:AGF). I have suggested removing "quackery" from the lead, but the pseudoscience claim is very well sourced and supported. You need to provide good reasons for removing these assertions, but I really don't think you can. The homeopathic point of view is already provided, and the mainstream scientific view must also be presented. At the moment there is no issue, so the statements should stay, and you haven't provided a good, encyclopaedic, reason for their removal that fits with wikipedia policies. --SesquipedalianVerbiage (talk) 21:22, 12 July 2008 (UTC)

There certainly is an issue and, if I understand Drpolich's point, I agree with it. For a comparative example, I happened to check my home medical encyclopedia the other day for its entry upon homeopathy which is:

"A system of alternative medicine that seeks to treat patients by administering small doses of medicine that in a healthy person would bring on symptoms similar to those that the medicine is prescribed to treat.

For example, the homeopathic treatment for diarrhoea would be a very dilute laxative preparation."

Now the work in which this appears is The British Medical Association Complete Family Health Encyclopedia. This is a reputable work, published under the auspices of the main professional body for medicine in Britain, and has sold over a million copies. That encyclopedia, like others we have considered, does not present the topic in the debunking way of the offending paragraph. Such comparative treatments are good objective evidence that our article is overdoing the critical content and so is neither NPOV nor good encyclopedia style. Colonel Warden (talk) 00:00, 13 July 2008 (UTC)

Your reasoning is flawed because Wikipedia has different rules. Checking other encyclopedias is always interesting, but we are required by the NPOV policy to edit in a different manner here. Here we MUST include significant controversies and criticisms. We must follow the references and describe all significant sides of the story. A personal website can tell one side, but here we tell it all. -- Fyslee / talk 20:08, 18 July 2008 (UTC)

Also, the focus of that encyclopaedia is medicine, not C/AM, so it only mentions homeopathy for completeness ans gives the briefest of overviews. WP has a much wider scope. That it doesn't give a more thorough discussion is telling. It would count as a very small stub in wikipedia. Notice the language is very carefully crafted "it seeks to treat" and the only mentioned effect of the substances is to "cause" similar symptoms. --SesquipedalianVerbiage (talk) 20:42, 18 July 2008 (UTC)

I can reference a number of studies that are positive for homeopathy and many have previous to my entering the discussion. Why is that not enough? If there is a single well done study out there that proves that homeopathy works better than placebo then you must question your statements. Because in no case would a glass of water be better than placebo. We don't have to worry about the weight of evidence. THIS IS NOT WESTERN MEDICINE. It is not an issue if homeopathy works for any single ailment. You say it can never, NEVER work due to the dilution. Thus, just one positive case or study proves you wrong. Does this make sense to you. I am hoping that the more scientific people out there will understand what my postulate is. Furthermore, If I did 100 studies of the efficacy of lexipro for hypertension then we would say Lexipro does not work. Obviously, it is the wrong study. I could easily set out to prove that Lexipro does not work. This is the problem with many homeopathic studies. They are the wrong study. Sesquip. are you an official of Wikipedia? If so, then I am wasting my time. I hereby request a change of personnel to someone who is more open minded. Drpolich (talk) 21:55, 12 July 2008 (UTC)

Hi, I'm not an official of wikipedia. Also, I wasn't the person that reverted you and I am trying to engage with you here. I understand that you think homeopathy works, and I assure you that if I saw scientifically rigorous evidence that homeopathy worked then I would too. I don't understand your reference to weight of evidence and "western" medicine. I also have a science PhD (I'm currently at a research conference in Iceland, where the constant sunlight is driving me mad while I'm trying to write my talk) - I'm only telling you this so you realise that I am a scientific person; this is not an attempt at argument from authority. Arguments have to stand or fall on their own merits. Why don't you post your ideas for studies on your talk page. To write the article, though, we have to rely on what is already published and out there. I also haven't said that homeopathy cannot work due to the extreme dilutions, I simply think it doesn't work due to the lack of compelling evidence after 200 years. If you want to post evidence on my talk page I'll read it, when I have time, and get back to you. --SesquipedalianVerbiage (talk) 22:14, 12 July 2008 (UTC)

The problem we run into is that many (most?) published studies on positive results for homeopathic preparations (including EVERY study I have looked into) are critically flawed. You can reference studies all day long, but if they do not employ proper controls, they are worthless. Feel free to post what studies you have, but be ready to have them thoroughly excavated. I have just looked at the online citation index (web of science), which is an extremely thorough database of clinical and basic science literature, and have found only one paper which makes any mention of a study of homeopathy and pediatric eczema: Hughes et al, "The use of Alternative medicine in pediatric patients with atopic dermatitis", Pediatric Dermatology, 24(2), 2007, p 118. Unfortunately, the sample size was small (34 patients) and herbal remedies were also studied. The conclusions? No benefit from alternative medicine, although these treatments caused adverse effects in three cases (doubtless it was the herbal preps, not the homeopathic ones). We've been over this several times. There is simply no evidence that homeopathic preparations work. The published studies are weak, the CAM journals often have no peer review criteria and are often little more than editorial in nature. The studies which do make it into peer reviewed journals are still generally flawed and, when positive, show lackluster, non-reproducible results. The positive meta analyses are also regularly flawed, often authored as an exercise in gross incompetence or intentional deceit. Your arguments here, while obviously in earnest, are part of the problem with validating homeopathy: to this day it stands only on anecdotal evidence such as "I have seen 6 year olds cured of eczema". That sort of evidence got you burned at the stake in Puritanical times. Publish a proper, statistically and methodologically sound study on the matter, with real, non-partial, non-subjective endpoints and, not only will you grace the cover of the journal "Nature" (and likely win a Nobel prize) but you will also start to sway the editors of wikipedia.Puddin'head Wilson (talk) 16:13, 24 July 2008 (UTC)

See Homoeopathic versus conventional treatment of children with eczema: A comparative cohort study for a peer-reviewed journal report on the matter. The results found homeopathy to be comparable with conventional treatments in effectiveness. Colonel Warden (talk) 21:17, 24 July 2008 (UTC)

Non placebo-controlled study with no control group, where the eczema symptoms are "assessed by patients or their parents" instead of being assessed by health professionals, and where it measures vague things like "quality of life" and "Disease-related quality of life" (and it's probably non-blinded, but the abstract does not make that clear). As Puddin says, you can present studies (positive or negative) but don't be surprised when they get picked apart by other editors on the talk page. --Enric Naval (talk) 22:53, 24 July 2008 (UTC)

I am not the least bit surprised. Please see No true Scotsman. Colonel Warden (talk) 23:53, 24 July 2008 (UTC)

I'm confused, Colonel. How does the "No true Scotsman" argument apply here? Overall, yes with several people contributing to the discussion and addressing various points along the way, it may seen that we are shifting our argument. But you have to remember we are not all sharing one brain, nor acting in consensus; I don't always agree with the arguments made by people I share an opinion with. That being said, Enric just stepped up and addressed your proposed evidence as I had suggested a reasonable editor might. And he's right on the money. Where's the Scotsman? Puddin'head Wilson (talk) 00:21, 25 July 2008 (UTC)

I don't see the scotman either, and I don't see how that vague alusion to fallacy-based bias helps to the discussion in any form. Consider instead bringing up examples of double-blinded placebo-controlled studies that can resist criticism.

Like this one [10], which has "individually selected homeopathic preparations (homeopathic study)" so it should address concerns about giving the same remedy to all the subjects, and has a pre-defined non-vague easy-to-measure-objectively measurement of success: "Reduction of area occupied by warts by at least 50% within 8 weeks". (mind you, it doesn't have a control group that receives no medication for comparison, so it's not perfect. It could be perfectly be that neither the conventional nor the homeopathic remedies had any effect, and that the eczemas cured themselves over tiem as part of a natural process. They probably decided on not adding a control group because two groups were already good enough to check the claim of homeopathy being more effective than conventional medicine on eczema treatment). --Enric Naval (talk) 01:04, 25 July 2008 (UTC)

Correct me if I'm wrong, but I think CW is intending we replace the evil Scotsman with our Scientist here. The problem is we haven't accused this paper of not being "true" science (there is no such thing, unless you mean maths ;) ). The analogy to "No true Scotsman" doesn't work, but it would if we changed the word true to "good", inventing the "No good Scientist" argument. However, the argument is no longer a fallacy if we do this; the Scotsman clearly isn't good, while his nationality isn't questioned. Bad Scotsmen exist, and we aren't claiming this paper isn't Scottish (metaphorically, I mean). --Verbal (talk) 06:38, 25 July 2008 (UTC)

Maybe he meant "no good study would have positive results for homeopathy". Which is a fallacy, since we are not talking about good or bad studies but about picking the best studies. Which is also a fallacy in itself, since what we should be doing is picking the best reviews, which have already done the work of picking among the thousands of existing studies, analizing them, weighting them, and giving a secondary source that we can cite. So I suggest we stop arguing about single studies and that we go for the reviews. --Enric Naval (talk) 15:59, 26 July 2008 (UTC)

I think what he meant is this: In the referenced allegory of the Scotsman, there is the news story of the Brighton sex maniac, which is akin to the going claims of the homeopathic supporters (please don't read into my comparison of the imaginary Brighton sex maniac with homeopathy; it is an allegorical parallel, and nothing more. Please see the "no true Scotsman" entry on Wikipedia for details). The skeptic response is that the claims of the homeopath are not valid without supporting research. This serves as the "no Scotsman would do that" argument. He then offered the requisite research, which parallels the second news report about the Aberdeen man, and "our" response was that the suggested study didn't stand to muster This he takes as an unjustified stance of "no true Scotsman would do that" or, in my personal wording, "that's not real research".

I don't think anyone has changed their qualifications of what will suffice as clear evidence that homeopathy's works. What "we" want is *quality* research; and this has been asked for all along. Just because worthless, poorly constructed, poorly executed, childish, fanciful, self-serving and, quite frankly, intellectually insulting "studies" are primarily offered as evidence of the value of homeopathy, and that they are continually and rightfully refuted, doesn't mean that "we" as skeptics are changing "our" standards.

Enric, we run into the same problem with reviews and meta-analyses as we do with the primary literature. For instance, Dana Ullman used to like to tote this particular meta-analysis of 60+, replicated studies: [Claudia M. Witt, Michael Bluth, Henning Albrecht "The in vitro evidence for an effect of high homeopathic potencies—A systematic review of the literature." Complementary Therapies in Medicine. Volume 15, Issue 2, June 2007, Pages 128-138. doi:10.1016/j.ctim.2007.01.011]. Problem is, if you actually read the paper, you'll find that only about 6 out of those 60 studies employed proper double blinded controls (and only half of those, with their own methodological flaws, came back positive)! For those who are not clear on the matter, this means that the vast majority of the included studies (>90%) are WORTHLESS. The review itself sounds quite impressive, as long as you don't bother to read beyond the abstract, but when you delve in, you find that it is a waste of ink.

I agree that *PROPER* reviews are invaluable. But I am confident that you can see the "Scotsman" argument coming back to haunt the talk page, particularly when a call is made for homeopathy friendly reviews and meta-analyses. These will continue to be offered up, and they will doubtless be later dismissed (or have already been dismissed) because they are as useless as most any other pseudo-research articles published in an editorial journal such as "Homeopathy". "Our" dismissal will then, of course, be attributed to some close-minded prejudice when, in fact, it is a reflection of a realistic and honest assessment of the review's true merit. Yes, the reviews are helpful and powerful when properly constructed, but it should be made clear that all reviews are not equal and they will be held to the same standards as the primary literature.Puddin'head Wilson (talk) 07:24, 27 July 2008 (UTC)

The source I cited above states, "There has been growing public demand for the application of alternative or complementary medicine to eczema and other allergic complaints. According to our own data, one child in five who attends a homoeopathic practice suffers from eczema. However, almost no data are available on the efficacy or effectiveness of homoeopathy for eczema: a meta-analysis carried out for various diagnoses included nine dermatological studies, but none dealing specifically with eczema. One single randomized, placebo controlled and GCP (Good Clinical Practice)-compliant trial was terminated prematurely owing to recruiting problems. The small evaluable population yielded no useful result. There is thus a major discrepancy between the widespread use of homoeopathic treatment for eczema and the lack of well-founded evaluations of such treatment." Puddin'head above made a search and could find no studies, which seems to confirm that there is a lack of such. This source then seems to be the best evidence available on the effectiveness of homeopathy when used to treat childhood eczema. It seems to confirm Dr Polich's point that the treatment has some merit and demonstrates that the evidence is more than anecdotal. So the conclusions that we might properly put in the article are:

Homeopathy is widely used for treatment of childhood eczema
The best study available indicates that it is as effective as other treatments such as corticosteriods.

Demanding studies which meet some idealised requirement before we say anything is inappropriate. We are not here to conduct our own meta-analysis of the merits of homeopathy but just to report on it as it exists in the real world. The real world understanding of allergic complaints such as eczema seems far from complete - no-one seems to know why they are increasingly prevalent. Personally, I am amazed that we seem to have a pandemic of such complaints and yet the medical world in general seems largely helpless. Requiring a perfect understanding, explanation or proof of the topic is therefore an unacceptable demand. Such perfection is not required of other topics and should not be required of this. Colonel Warden (talk) 09:51, 27 July 2008 (UTC)

(unindent) If this study (primary source) is really relevant, then it will get picked up by medical reviews (secondary source) as an example of homeopathy really working. If it's not mentioned on any review, then it's just a study hand-picked by a wikipedia editor from literally thousands of studies using his personal criteria.

Now, if you were to present a study that other editors can agree that is a strong study, because of having a famous reliable author or having really good quality or other circumstances, then it would be different as you would have consensus for it being appropiate for inclusion despite not being mentioned on a review, but this is not the case.

P.D.: also, from where do you infer that "Homeopathy is widely used for treatment of childhood eczema"? The quote says that there is growing demand, but it could perfectly mean something like a growth from 3% to 5% of the total children with eczema being treated with homeopathic remedies?

P.D.D.: We don't "report on it as it exists in the real world", we report on it as published reliable secondary sources report it. A clinical trial is a primary source. --Enric Naval (talk) 14:12, 27 July 2008 (UTC)

I'm willing to accept the assertion that homeopathy is being widely "used", as much as one can "use" a glass of water to treat disease, or to start a car for that matter. Where I get concerned, Colonel, is when you make the unwarranted jump in logic to state that "The best study available indicates that it is as effective as other treatments such as corticosteroids." Where in that abstract you quoted is there any mention of corticosteroids? How do you interpret that abstract to ,in any way, suggest that homeopathy is useful? All it says to me is that some homeopaths try to treat childhood eczema, but there is no available evidence that it has any effect. Lack of any evidence is certainly not grounds to state that the fundamentally illogical claims of homeopathy are valid. How did you come to this conclusion?Puddin'head Wilson (talk) 14:42, 27 July 2008 (UTC)

I think that conventional medicine uses mainly corticosteroids for treatment of eczema on children. "Topical corticosteroids are widely prescribed by dermatologists caring for patients with atopic eczema."[11] "In cases of moderate to severe eczema, corticosteroids are often prescribed by a doctor or dermatologis" http://www.ehow.com/how_2284094_use-corticosteroids-eczema.html, "Topical corticosteroid formulations are the mainstay in treatment of psoriasis, eczema, burns and ulcers"[12] so that jump is not that unwarranted. --Enric Naval (talk) 16:52, 27 July 2008 (UTC)

Verily, but it needs to be made clear that Colonel Warden's conclusion that homeopathy works just as well as the standard treatment, based on the quoted material offered, simply doesn't follow. If anything, the quoted passage suggests that there is no reason to believe that homeopathy will have any effect in these cases. —Preceding unsigned comment added by Puddin'head Wilson (talk • contribs) 13:28, 28 July 2008 (UTC)

Nonsense. The study was intended to fill this gap and having done so, it is reasonable to report its conclusions until a better study comes along. As for the details, the paper says things like, "For 50 years topical, and in severe cases systemic, corticosteroids have played an important role in the treatment of children with eczema, but long-term use causes concern for many physicians and parents because of skin atrophy and other potential side effects." ... "According to our own data, one child in five who attends a homoeopathic practice suffers from eczema." ... "the widespread use of homoeopathic treatment for eczema". Your refusal to accept this study seems to be based upon ignorance and prejudice. This is not a NPOV and so should be discounted. Colonel Warden (talk) 18:33, 30 July 2008 (UTC)

I checked the "Research on medical effectiviness" section to see where we could insert this study, and I see that the NCCAM says "In sum, systematic reviews have not found homeopathy to be a definitively proven treatment for any medical condition. (...) Examples of problems they noted include weaknesses in design and/or reporting, choice of measuring techniques, small numbers of participants, and difficulties in replicating results."[13].

That study of eczema has some if not all of those problems. Adding it to the article as a proof of anything would simply be undue weight and contradicting reliable notable sources. This is a clear example of why we need to leave it to medical reviews to decide which studies are really relevant. Also, homeopathy has a lot of medical reviews, so, even if we only use reviews we still cover all the research adequately. This is not a case when there is a lack of secondary sources and we need to go to primary sources. It's the other way around, with lots of adequate published secondary sources.

Seriously, use some medical review instead. --Enric Naval (talk) 21:02, 30 July 2008 (UTC)

Why is it that all studies offered in support of homeopathic claims seem to be conducted by folks who are utterly ignorant of what qualifies as quality research? This is nothing personal, but just an observation on the state of the available research. Colonel, the study you have presented on Eczema has *at least* one glaring flaw in it. After reading the study, it would appear that the conventional physicians were left to evaluate the patients which they had treated, and the homeopaths were left to evaluate the patients they had treated! Of course the homeopaths are going to report remarkable effectiveness. Why should one even believe that the homeopaths even understand how to fill out the standard evaluation form used by the dermatologists and pediatricians in this study? Without any controls, and the obvious propensity towards prejudice by those reporting the effectiveness of their treatments, the study is worthless. As has been stated ad nauseam, the wealth of properly designed, controlled, blinded studies continue to show no significant effectiveness for homeopathic remedies. At best, you may have an argument that the conventional remedies are no better than placebo, but this has no bearing on the effectiveness of homeopathy. Also, nothing you have quoted in your above response in any way makes a case for the effectiveness of homeopathy. You've made it clear that children get eczema... conventional treatments are not always satisfactory... many people turn to homeopathy... but where in these statements do you come to the conclusion that homeopathy has any effectiveness in treating this condition? People pray all the time, it doesn't prove anyone is listening.Puddin'head Wilson (talk) 04:18, 31 July 2008 (UTC)

It is logically impossible to prove such a proposition - this is medicine not mathematics. We were discussing the matter of eczema specifically and the study which I found seems to be the only significant one, having being conducted specifically to address the gap in coverage of this condition. The idea of a general review of such studies is therefore also logically flawed since we have only one study. Anyway, we need to focus upon what is to be said in the article. It would be useful to add some content which detailed the conditions which homeopathy is commonly used to treat and we can then report the findings of whatever studies exist for those complaints. I recall coming across a source which indicated that people tended not to use homeopathy for complaints which were life-threatening. An example, I suppose, would be acute appendicitis. I further suppose that patients might use homeopathy for chronic complaints like eczema for which conventional medicine is unavailing. I shall keep my eyes open for general surveys of the pattern of usage of homeopathy across the vast range of illnesses. Colonel Warden (talk) 21:36, 30 July 2008 (UTC)

I did a little browsing and soon found a meta-analysis of this sort: The research evidence base for homeopathy: a fresh assessment of the literature. This found: "Considering the relative number of research articles on the 35 different medical conditions in which such research has been carried out, the weight of evidence currently favours a positive treatment effect in eight: childhood diarrhoea, fibrositis, hayfever, influenza, pain (miscellaneous), side-effects of radio- or chemotherapy, sprains and upper respiratory tract infection. Based on published research to date, it seems unlikely that homeopathy is efficacious for headache, stroke or warts. Insufficient research prevents conclusions from being drawn about any other medical conditions." I shall look around some more and then add a section on the effectiveness and usage of homeopathy for different conditions. Colonel Warden (talk) 22:30, 30 July 2008 (UTC)

That looks a quite better approach than using individual studies. --Enric Naval (talk) 22:41, 30 July 2008 (UTC)

Give me some time to look into this review but, as stated above, it has been my experience that the reviews which cast homeopathy in a positive light are of little better quality than the primary research. I can already comment that the oft referenced studies demonstrating effectiveness in childhood diarrhea are, by their own standards, short of a statistically relevant sample size and are lacking any strict controls.Puddin'head Wilson (talk) 04:18, 31 July 2008 (UTC)

Again we see the No true Scotsman effect. When anecdotal evidence is presented, you ask for a study. When a study is presented, you ask for a meta-analysis. When a meta-analysis is presented, you start fishing around for reasons to discount it. This is overt bias. Now the results I presented were the results of quick searches. Others have looked into this more deeply and it seems that such bias is found even in reputable journals, e.g. "A more recent review started from the premise that ‘specific effects of homoeopathic remedies seem implausible’. Of course this does not excuse the remarkable opacity of this review, which gave no hint of which studies it was based on and did not include a sensitivity analysis, among other failings. Still less does it excuse a recent commentary in The Lancet which opened with the statement that: ‘Five large meta-analyses of homoeopathy trials have been done. All have had the same result: after excluding methodologically inadequate trials and accounting for publication bias, homoeopathy produced no statistically significant benefit over placebo.’ In fact only one of the large meta-analyses of clinical trials of homeopathy included correction for both publication bias and trial quality, and it showed precisely the reverse: effects of homeopathy remained significantly greater than placebo when these, and other, corrections were applied singly or in combination. Remarkably, the commentator omitted even to cite this article, although it was published in the same journal.". These observations have the nature of a meta-meta-analysis and it seems that publication bias is still dominant in determining the conclusions. Our article has the same blinkered quality, making absolute statements like, "Homeopathy is unsupported by modern scientific research." which can only be made by a selective choice and interpretation of sources. This is not a NPOV presentation. Colonel Warden (talk) 06:53, 31 July 2008 (UTC)

Colonel, one advice, you don't need to engage any more on this discussion. Stop wasting time on this argument, disengage from this discussion. Take your time to find the reviews you need and write a good text based on those reviews. And, for discussing that new text, I advice that you take the initiative and you open a new section at the bottom of the page to center the discussion as soon as you add the text on the article. This section is now too convoluted for useful discussion of a new text. --Enric Naval (talk) 08:50, 31 July 2008 (UTC)

I'm mostly just following my nose, one post at a time, but having reached the level of meta-meta-analysis, agree that we are at the end of that line of discussion. I'm not sure I'm going to waste much time on preparing something for the article because such effort seems unproductive, given the knee-jerk opposition that tends to result. I observed before that I didn't feel that the article had improved much over the years. I was just browsing and read the Quackwatch entry. I found even this to be better reading than our article and was interested in what it had to say about homeopathy's classification of personalities - the nux vomica type, etc. Our article doesn't have these details and so is deficient in explaining the topic. It is sad that so much effort is resulting in so litle value. Colonel Warden (talk) 09:53, 31 July 2008 (UTC)

Well, that's a pity :( . I only opposed because of using primary sources, I'm OK with using medical reviews to source that.

About the homeopathy types, the reason because they are not included is because they are part of classic homeopathy, and the article doesn't cover it for some reason. The history section simply skips over the work of Constantine Hering and James Tyler Kent. This article says "the well-known Kent repertory, on which virtually all modern practise of homeopathy is based", so I guess he must be sort of important on homeopathy.... --Enric Naval (talk) 10:40, 31 July 2008 (UTC)

I've given Colonel Warden a warning about being uncivil. PhilKnight (talk) 20:50, 30 July 2008 (UTC)

The Scotsman argument is still flawed. Colonel, you are suggesting that after offering anecdote, your were told "not good enough, give us studies". After providing studies, you were told "not good enough, give us reviews", and this is the basis for invoking the "no true Scotsman" argument. But here's the rub: those which have been offered as "studies" are not studies at all, but merely coyly disguised advertisements from editorial journals such as "Homeopathy". You are not giving us what we are asking for, even though it would appear that you are. It's as if I asked for a rose and you hand me a pineapple and simply decide to call it a rose. Calling it a rose doesn't make t so. Calling a bunch of loosely organized data with no proper controls a study doesn't mean it is actually a study. There are criteria by which any reasonable person familiar with the notion will judge a scientific study. Enric is familiar with this problem with the quality of "studies" published in support of homeopathy in the CAM journals and rightfully asked for QUALITY reviews. But you are just giving us reviews of equally poor quality from the same CAM sources, an entire box of pineapples, if you will. This is why we keep running into these issues; you are missing the fundamental problems that plague these efforts in creative writing which are masquerading as scientific studies.

You have made some passing mention of a recent Lancet review, but have not referenced it (at least not in your most recent entry here), nor have you pulled any quotes from it which would imply that it actually paints homeopathy in a positive light. If you can find some real conclusions in there which suggest that homeopathy is actually of some value, I think you will find it a lot easier to pass it by the rest of the editors. Which Lancet review are you referring to?Puddin'head Wilson (talk) 18:55, 31 July 2008 (UTC)

Placebo effect on infants, animals and children

I asked this on my talk page and did not get a response. Many have said that placebo works on infants, animals and children. What studies have shown that? I am only aware of those that do not work on infants etc. I am surprised that an infant or animal has the mental ability to even know that they are being treated let alone "believe that they will get better and therefore get better". If there is a documented placebo works on them then it must not be placebo which gets really weird. Drpolich (talk) 15:57, 19 July 2008 (UTC)

The effect is on the people reporting the improvement in the condition, as the patient cannot report themselves. If the owner of a dog, for example, expects it to get better with a sugar pill, then they will probably report that there has been some level of improvement. It does not rely on the animal even being aware it is being treated - although the extra attention lavished on the animal could also produce a beneficial effect. This is thought by many to be an extension of the placebo effect to the observers who believe there will be an improvement, and is taught about in veterinary school. It is also often termed observer bias, although in this case it is unintentional. The belief can also cause incorrect attribution of improvement to the placebo, when the cause was actually more mundane. With children, the effect is commonly exploited by mothers and is discussed under various names in many parenting books. So it is an effect on those observing the patient in this case. --SesquipedalianVerbiage (talk) 16:43, 19 July 2008 (UTC)

Ses, where is your research to support your statements? Also, let me add, the changes seen in homeopathy are objective symptoms not just subjective symptoms. So there is no reporting. On my website I have photos and measurements to support the claims that it works on infants. How do you explain that? Drpolich (talk) 22:15, 19 July 2008 (UTC)

Anybody can set up a website. The fact that your website exists is therefore not surprising and needs no further explanation. Tim Vickers (talk) 00:04, 20 July 2008 (UTC)

As for photographs and measurements posted on a website: without a large enough sample and a control group to show how the condition of infants who were treated with a placebo progressed, they won't provide any evidence that the intervention actually caused the improvement. Without a control group you're just relying on the post hoc ergo propter hoc fallacy again. Brunton (talk) 07:41, 20 July 2008 (UTC)

The control is the fact that without treatment or even with helmeting the skull normally takes more than 4 months to change by 15mm (see website for details) and homeopathy did it in 1.5 months. Anyway, my main question is what research data supports the idea that infants are susceptible to placebo. As you have pointed out many times in homeopathy, we need a weight of evidence in research and no other information is relevant. Certainly, references in parenting books is not a reliable source without research. Ses, you surprise me. Drpolich (talk) 19:06, 20 July 2008 (UTC)

1. The placebo effect comes about from expectation of an outcome. As has been clarified several times above, the issue is not that an infant is cognizant of therapy, but that its parents are. Since it is the parents who are reporting on disease progress, their expectations and wishful thinking are very pertinent and prone to distort their assessment.

2. Hopefully having that finally clarified, the placebo effect needn't even be invoked for this discussion. After all, you have nice pictures to make your case obvious. It is very important that you realize that pictures of a baby's skull or fading eczema do not serve as proof that homeopathy works. In the eczema case, how do you know that the parents didn't change soap, or kleenex, or eliminate some other possible allergen? With a sample size of one, it is impossible to account for every possible variable which may have had an effect on that child. Not to mention the well known phenomenon of spontaneous remission.

In the case of helmeting, 4 months for 15mm is an average' progression'. The most logical conclusion one can come to is that this particular child is simply ahead of the curve. It is absurd, and quite frankly irresponsible, to suggest that homeopathy, without a doubt, cured these children, or had any effect on them whatsoever. Strictly speaking, given the fact that there is no reason to believe that extreme dilutions will have any physiological effect whatsoever, it is just as likely that the speed of the car these children were driven home in was responsible for their improvements. Puddin'head Wilson (talk) 00:21, 25 July 2008 (UTC)

Dr. Polich, in response to your question on research which verifies that the placebo effect is known to manifest itself in children, I have two things for you to consider. It is common practice to use blinded placebo studies in the analysis of pediatric treatment methods, just as with any other study. You can check the primary peer reviewed literature to verify this. Just because one doesn't expect the placebo effect to be pertinent doesn't mean we can ignore it. Remember that the use of a placebo (i.e. proper control) can help correct for several methodological errors which would lead to false positives, even if the placebo is itself not bringing about any effect. The second consideration is simply one specific example. If you read the following review, and its referenced studies, you will see instances where infants showed marked response to placebos in studies of gastroesophageal reflux disease: Hibbs et al, "Metoclopramide for the treatment of gastroesophageal reflux disease in infants: A systematic review", Pediatrics 118(2), p 746, 2006. It is a known phenomenon.Puddin'head Wilson (talk) 17:17, 28 July 2008 (UTC)

Also, Enric has added a few studies showing the effects discussed to the discussion on Dr Polich's talk. Verbal chat 17:59, 28 July 2008 (UTC)

Lead - "contend" should be changed, perhaps to "maintain"

One minor change that would be a start at reducing the biased tone of this article: In the second sentence, rather than saying "homeopathics contend that...", and thus defining the position of homeopaths and their supporters in opposition to mainstream scientific opinion, the article should say "homeopathics maintain that..." (or choose a better, more neutral word if you can think of one).

this would be a positive definition rather than a negative one. surely this is a very basic requirement? The statement "a hill is a topographical feature" is superior to "a hill is not a living organism" for purposes of definition.

it would also be more accurate since homeopathy predates current mainstream scientific opinion and should not therefore be defined initially in relation to it. --Jethrobrice (talk) 16:28, 2 August 2008 (UTC)

I agree, and i have made the necesary modificaitons to the text to reflect the consensus that we and I have reached. Smith Jones (talk) 17:02, 2 August 2008 (UTC)

This change is extremely minor. Is contend really controversial? I contend that it isn't, and that is this is a pointless change - but changing it back would be equally pointless (believe might be a better word, but that would probably be very controversial - although it is common to say that scientists/experts believe...). A more important point: you state the tone of this article is biased. Could you elaborate which parts in particular so we could work on these? If your contention is with the scientific view being in the lead then please look through the archives here. The hill analogy seems to be a straw man (it doesn't work,like the "no true Scotsman" argument above). I would contend and I believe, and I would also maintain, that a hill is a geographical feature. Some might claim that hills are alive, though.

Re homeopathy pre-dating the science, I don't quite see the relevance. Firstly, this article deals with homeopathy now; it is not a history article. Therefore homeopathy should be discussed and framed in its current context. The history should be summarised, and this is how the article is currently written. Secondly, leaving out the scientific evaluations of homeopathy would violate wikipedia policy. Thirdly, since it is an important part of the article it should be summarised in the lead. These are just a few reasons. Verbal chat 17:45, 2 August 2008 (UTC)

Consumer Reports, April 2008

A notable article has created quite a stir in the homeopathic community. Consumer Reports is a RS and it can/should be used as a source here. The on-line article can be found here:

"Homeopathic remedies can cause confusion" - by Doug Podolsky, senior health editor. This article first appeared in the April 2008 issue of Consumer Reports on Health.
Google search
Reference format: <ref name=Podolsky>Doug Podolsky. "[http://blogs.consumerreports.org/health/2008/03/homeopathic-rem.html Homeopathic remedies can cause confusion]". ''[[Consumer Reports]]'', April 2008</ref>

-- Fyslee / talk 03:19, 8 August 2008 (UTC)

Homeopathy article in the Journal of Head Trauma Rehabilitation

Veterans with mild traumatic brain injury may benefit from homeopathy per the article in the Journal of Head Trauma Rehabilitation, December 1999, page 521, on the randomized, double-blind, placebo-controlled NIH Pilot study performed at Spaulding Rehabilitation Hospital in Boston.

Scientific explanations may relate to the non-linear effects being discovered and now labeled "low-dose toxicity". Previously, scientists believed that effects decreased as concentrations decline, but that is no longer the case. A recent symposium recently took place featuring several eminent scientists at Villanova Law School, Villanova, Pennsylvania due to the emerging legal implications of this discovery.

Another recent developement is the discovery of stable water clusters at room temperature and normal pressure referenced in Lo et al, Modern Physics Letters B, 10, 909 (1996) and in paperback as "Proceedings of the First International Symposium on Physical, Chemical and Biological Properties of Stable Water [Ie trademark] Clusters", editors S.Y.Lo & B. Bonivida, 1997, World Scientific. These clusters are being investigated as of 1997 for industrial applications. Their preparation parallels the discovery by Dr. Samuel Hahnemann of the special effects of low doses formed through serial dilutions with intervening succussion.Aude4Sapere (talk) 00:39, 10 August 2008 (UTC)

What part of "pilot study" are you not familiar with? The rest is just "this science sounds a little bit like homeopathy - let's run with it." - much like all homeopathy apologetics. Shoemaker's Holiday (talk) 01:09, 10 August 2008 (UTC)

Wikipedia publishes established science. There was a Lancet review on 2005 that discounted the effects of homeopathy. If this study was really relevant and if it proved any effect, it would have been noted at that review. --Enric Naval (talk) 10:11, 10 August 2008 (UTC)

Something that was published in 1996 hardly counts as a "recent development". Dr. Lo seems to have been developing a "quantum theory of acupuncture", BTW. Brunton (talk) 13:43, 11 August 2008 (UTC)

more scientific approach

I would like to suggest that a more scientific approach is used for this topic.

This subject is so contenscious with so much at stake, including the credibility, the integrity and livelihoods of individuals and companies on both sides of the spectrum.

The subject matter should first be written by experts in that field.

It can then be open to peer review on the actual science behind the subject matter. This is the methodology that all scientific papers go through in academia, so why not use the same methodology here?

The current page is so obviously written by an unqualified experts attempting to write about subject matter which they have little or no knowledge about or drawing on some articles read and disputed papers which are in themselves questionable. Frictionfree (talk) 10:18, 14 August 2008 (UTC)

I think that you are looking for Citizendium, the wiki where experts are given more rank that non-expert editors. This is wikipedia, the encyclopedia that anyone can edit (third pillar). You can look at the homeopathy article on Citizendium.

If you want to discuss the general issue about experts editing wikipedia, or about wikipedia articles should be written mostly or only by experts, then please don't use this talk page, as article talk pages are for discussing changes to the articles. Use instead Raymond's page on expert withdrawal, the talk page of Wikipedia:Expert retention, or Wikipedia:Village pump (miscellaneous) --Enric Naval (talk) 13:42, 14 August 2008 (UTC)

If you could tell us which parts you have problems with specifically, and why, maybe we could address those concerns. Verbal chat 14:19, 14 August 2008 (UTC)

The problem with having the article written by "experts in the field" rather than, as you describe them "unqualified experts" is that the only people likely to have actual qualifications in homoeopathy are practitioners, who are obviously going to have a conflict of interest. There are plenty of editors here who, while they lack formal qualifications in the subject, are quite capable of evaluating the evidence for the efficacy of homoeopathy. Many of them have also read extensively about homoeopathy. It is not necessary, for example, to have detailed knowledge of the homoeopathic materia medica to write an article of this type.

Looking at the Citizendum page, which is written by "experts in the field", I only managed to get as far as the first sentence of the introduction before spotting an inaccuracy: "Homeopathic medicines treat an illness with an infinitesimally small dose of a substance that, at larger doses, can cause symptoms that are like those of the illness". This ignores the fact that provings are in fact carried out using potentised remedies, not "larger doses", and usually at the 30C potency (as recommended by Hahnemann himself in The Organon - see § 128, 5th and 6th eds.), which has no molecules from the mother tincture present. Brunton (talk) 15:29, 14 August 2008 (UTC)

Well, User:DanaUllman is an editor there. It shows some of the problems with Citizedium. Jumping through those hoops is something that people with an axe to grind will waste their time on. Let's stick to detailing and fixing any specific problems with this article. Verbal chat 20:37, 14 August 2008 (UTC)

Important study missing?

I wonder why there is no mention in the article to the well documented Madeleine Ennis' study about water memory and its possible relation with homeopathy. Guillep2k (talk) 17:49, 26 August 2008 (UTC)

See the water memory page, and the page on Dana Ullman. If you think it should be included, please give a reason. Thanks. Verbal chat 17:55, 26 August 2008 (UTC)

NPOV tag

As most issues have been addressed or reached stability, I think it is time to remove the neutrality tag. If anyone has objections please document them briefly but with specificity below, so that they can be dealt with. Permanent tagging of the article is not an option. Verbal chat 14:47, 27 August 2008 (UTC)

We already have a section above and have had sections before. Proliferation of such sections dilutes the criticism rather than concentrating it and so is not helpful. I might comb the archives and assemble all the unresolved issues here but this will take time. Colonel Warden (talk) 15:03, 27 August 2008 (UTC)

Other sections have had large discussions and changes were made to the article in response. Unless there are new issues, or issues you'd like to bring up again, then I would think this matter is closed. Why not remove the tag, and bring one issue at a time as you find it. We can then ask for input on various noticeboards/projects to try and get each one dealt with. I want to move the article forward, not get it stuck in NPOV-tagged hell. For example, how we dealt with the Naturopathy split and removal - one topic given a brief bit of focus and quickly resolved to the agreement of all (I think!). Verbal chat 15:14, 27 August 2008 (UTC)

The matter is not closed and the long history of this article indicates that it is unlikely to be resolved easily. See WP:EDCO for a related proposal to resolve protracted disputes of this sort. Colonel Warden (talk) 15:36, 27 August 2008 (UTC)

No reason not to try. So if you don't mind I'll start the ball rolling in a moment, after checking something. Verbal chat 15:39, 27 August 2008 (UTC)

neutrality of tone

mention of scientific opinion could be much more concise, limited to a few well-phrased sentences.

bias is not merely a matter of whether statements can be backed with references - it is also a question of tone, rhetorical structure, and emphasis.

--Jethrobrice (talk) 16:28, 2 August 2008 (UTC)

I agree, and i have made the necesary modificaitons to the text to reflect the consensus that we and I have reached. Smith Jones (talk) 17:02, 2 August 2008 (UTC)

For the future, Smith Jones, you would be well-advised not to claim a 'consensus' has been established based on your agreement with one other editor's half-hour-old comment. That said, the very minor changes that you've made under the banner of that 'consensus' seems innocuous: [14]. ('Contend' and 'maintain' both implicitly acknowledge that homeopathic principles are not universally accepted.)

I hope that you don't choose to strip out the detailed scientific discussion of homeopathy from the article as Jethrobrice suggests. There is ample discussion – dare I say 'consensus'? – in the archives of this talk page to see that such a change is unsupportable. Homeopathy wishes to be recognized as a legitimate science and genuine branch of medicine—it is both fair and appropriate that Wikipedia include a reasonable discussion about what science medicine have to say of homeopathy. TenOfAllTrades(talk) 17:38, 2 August 2008 (UTC)

I agree with TenOfAllTrades, and would refer the reader to my answer in the thread above. Verbal chat 17:46, 2 August 2008 (UTC)

Hey hold on ther e Sindney. I never asaid that I wanted to strip off the scienfitific discussion; I agre that it should remian in place as an integral part of the Homoapthy article. I only said that the word "contend" was used too often. I counted SEVEN uses in the lead and the opening paragrapsh alone, and I find that it WP:MOS was getting repetitive. I changed it to maintain not to alter the meaning (I know that the mean rouglhyl the same thing) but to create variety and to make this article more interesting to read.

The way it was was good, and I am not criticizing all of the hard work that people who hav eplaced into this article have done, but that in our effort to avoid any even minor disagreement we have made this article a bit dry and boring to read. By creating verbal variety, it might be making this article a little bit more engaging and less repetitive.

If you want to revert my edit and vangate our consensus, then go ahead; I will not object or change it bakc. I was only attempting to make a few cosmetic changes and I am sorry if i cause d offense. Smith Jones (talk) 18:04, 2 August 2008 (UTC)

Er, 'vangate'? In any event, you seemed to be agreeing with Jethrobrice's statements in two separate sections on this talk page (albeit with the same comment in both). This thread deals with a proposal to reduce the section on scientific consensus to "a few well-phrased sentences"; the thread above this one deals with a change of word (from 'contend' to 'maintain'). Did you inadvertently copy your comment into both sections? That may be where the confusion arises.... TenOfAllTrades(talk) 18:12, 2 August 2008 (UTC)

that is improbable but I will conceed that it might have occured in the fashion that you described. if the story that you are telling me turns out to be true, I will of course oppose any such move. Paring down the scientific consensus serves only to create bias and will delegitimize homepathy by making it seem as if scientific controversy does not exceed regarding this subject.

I oppose any such manoevers on the part of any article editor since all it does is reduce the weight that scientific discussion re: Homeopathy exists on the scientific literature, wihch is a debate that we have gone through literally thousands of times if you will look at this archive. This seems obvious and I am surprised that i have to go through this twice.

In regards to consensus; i was not aware that it was okay to break consensus and make sweeping edits like the one being proposed. I have read all the rules but it doesnt work. Smith Jones (talk) 18:17, 2 August 2008 (UTC)

(← unindenting) Smith Jones, I don't think I understand what you're saying. If you scroll up to the top of this section (just under where it says neutrality of tone) you'll see a comment by Jethrobrice where he says that discussion of science in relation to homeopathy should be pared down to "a few well-phrased sentences".

Immediately below that, you'll find the comment that you wrote and signed (diff) where you apparently agreed with Jethrobrice's position, and you indicated an intention to go ahead an edit the article based on the two-person 'consensus' so established.

It seems from your more recent remarks here that you don't agree with that comment by Jethrobrice, and that you only inadvertently made your comment here in this thread. (Either way, you should be more cautious in claiming a 'consensus' in this way—two people and a half-hour of discussion don't generally serve to establish a consensus, particularly on a high-traffic, high-controversy article.) TenOfAllTrades(talk) 18:27, 2 August 2008 (UTC)

(edit conflict with ToAT) Smith Jones, I think you've got a bit muddled here. Maybe you want to strike out your first comment in this section if you disagree now with it, and added it by accident. I also don't follow your logic above, but I think I agree with you. Obviously, changing the article against consensus isn't allowed except (one hopes) in extreme cases. Per my comment in the thread above, I'm against any removal of the scientific analysis without good reason. "Neutrality of tone" seems to be a new method to try to change the balance to favour a particular bias, neutral or not. Verbal chat 18:33, 2 August 2008 (UTC)

Maybe youre right. I will WP:AGF and trust your judgment re: this matter, but personally I dont feel that this article reamins as volatile and dangerous as it once was, and the fact of the matter is that the other edit that I made was only an extremely minor comsetic edit that I am not that attached to you said it was. You are right that I might have misposted the comment twice, in that case you can disregard this descussion and I will go back and strike through the inappropriately placed comment. I DO NOT agree with Jechothmann's second comment, only his first on re: contend v. maintain. That are all. Smith Jones (talk) 18:34, 2 August 2008 (UTC) (fixed by Verbal chat)

I agree with Jethrobrice's point which has been also been made previously by many other editors. The article still has a tendenditious tone which is inappropriate here and is not NPOV. I have reverted removal of the POV tag accordingly. Colonel Warden (talk) 13:23, 27 August 2008 (UTC)

Start a new section with documenting your concerns, with specificity. The issues brought up here have not reached a consensus. I will ask you to revert he placing of the tag until you have done so. Please place any new comments in a new topic as this one has strayed very far off topic. Note that disruption includes the constant tagging of articles and stonewalling of progress. There has been plenty of time to develop points, and since the article is now stable the tag should be removed unless you or others give reasons, with specificity, why it should remain. Otherwise the points can never be addressed. Verbal chat 14:45, 27 August 2008 (UTC)

We had at least one previous section of this sort which has scrolled off into the archives without being resolved. Now we have another section here of a similar sort. I have briefly reviewed the article to see if adequate improvements have been made and they have not. Since multiple editors object to the article's tone, the tag stays until resolved. I shall perhaps add further tags to indicate specific areas of concern but dislike excessive tagging. More anon. Colonel Warden (talk) 14:57, 27 August 2008 (UTC)

It would be better to tag with specificity, then we can fix it. There are verification tags, check tags, disputed and bias tags that can all go inline and show exactly where the problem is. There is even a not supported by source tag. If a subsection is a problem, tag that as a whole and provide a justification. That would be much more useful than tagging the whole article and saying that there is a tone issue. So I would encourage you, and others, to go through and tag bits they feel don't meet policy, rather than leave the article as it is now. However, I also don't like excessive tagging so, for example, tag paragraphs or sections rather than every sentence in the paragraph or section. Let's fix this article! Verbal chat 12:30, 11 September 2008 (UTC)

Quackery in the lead

Resolved

Several people, mostly homeopaths, have commented that they don't like the word quackery appearing in the lead. Now I agree that it should be included in the article, as it's verifiable, a common opinion, and from a reliable source. However, for the lead I feel that the term pseudoscience is enough. I would suggest keeping the sentence in the lead up to the semicolon (replaced with a full stop), and integrating the remainder into the body of the article. Perhaps into the "Research on medical effectiveness" section or the 20th century section. This is something I've suggested before but which has been overtaken (usually) by discussions as to whether homeopathy works, so please lets keep his on topic: quackery removed from the lead, put somewhere else. Verbal chat 15:46, 27 August 2008 (UTC)

Agreed. Quackery means charlatanism etc. as opposed to well meaning but (in all probability) misguided practices in the name of medicine. Both fall under the topic of the article, but to get into that distinction so high up seems less than ideal. Baccyak4H (Yak!) 16:26, 27 August 2008 (UTC)

Disagree. Wikipedia also defines quackery as "unscientific medical practices," according to the lead in Quackery. Hiding this significant point down the page because some people don't like it -- some with vested interests -- would not be in keeping with policy which says the lead is "..... a short, independent summary of the important aspects of the article's topic." An important aspect of homeopathy is that it is widely considered to be quackery. Even Verbal, who started this section, says homeopathy being quackery is "verifiable, a common opinion, and from a reliable source". Consider the following. Would you drop the words "would violate the first and/or second laws of thermodynamics" from the lead of Water-fuelled car, or (it) "is a scientifically refuted speculation" from the lead of Water memory, or (it) "directly contradicts many principles of modern physics, chemistry, and biology" from the lead of Therapeutic touch ? . Kaiwhakahaere (talk) 01:57, 28 August 2008 (UTC)

My point isn't to hide it, but currently quackery isn't mentioned elsewhere in the article - I should have said this in my summary above. Pseudoscience seems to be enough of a summary for the lead. I wouldn't support dropping those terms from the other articles. Establishing consensus on whether it should be in the lead or "just" the article body is the goal here. Maybe this should be an RFC. Verbal chat 06:20, 28 August 2008 (UTC)

You seem intent on trying to bypass Wikipedia policy. You give two reasons, because homeopaths don't like an accurate description appearing in the lead, and you think the word pseudoscience seems to be enough of a summary. You totally ignored what I just wrote above, that one Wikipedia definition of quackery is "unscientific medical practices." By substituting pseudoscience for quackery the article would no longer be informing readers that homeopathy is an unscientific medical practice. Censorship. Kaiwhakahaere (talk) 09:42, 28 August 2008 (UTC)

I think there is a bit of confusion here - I've tried to explain myself on your talk page. I really do not condone censorship in any form. Verbal chat 10:25, 28 August 2008 (UTC)

The term unscientific is more NPOV than either pseudoscience or quackery since it is less pejorative while communicating the point. See WP:AVOID: Such terms often convey to readers an implied viewpoint—that of the "outsider looking in and labelling as they see it". The fact that a term is accepted "outside" but not "inside" is a good indicator that it is pejorative or inflammatory in nature.. Colonel Warden (talk) 09:58, 28 August 2008 (UTC)

Removing the term pseudoscience is not the topic of this section, and consensus on pseudoscience appearing in the lead has been clearly established and is in line with wikipedia policies as mentioned above by Kaiwhakahaere. Verbal chat 10:20, 28 August 2008 (UTC)

The general problem here is the use of polemical language. This is not good NPOV style. User:Kaiwhakahaere wishes to communicate that homeopathy is thought to be an unscientific medical practice. I find these words to be acceptable and preferable to other terms which are known to be pejorative. We should not seek to use derogatory language when more NPOV alternatives are available - this is the clear guidance of WP:AVOID. Colonel Warden (talk) 11:16, 28 August 2008 (UTC)

If they article said "homeopathy is quackery", then you would be correct. However, the article words it as "...regarded as..." which is perfectly true and neutral, with appropriate cites to reference which demonstrably regard homeopathy as such. Jefffire (talk) 12:23, 28 August 2008 (UTC)

I agree with Jefffire - there is nothing wrong (against policy) with any of these terms appearing in the lead. Pseudoscience should definitely stay. Verbal chat 12:31, 28 August 2008 (UTC)

(Undent)As an outsider just watching, my opinion from reading the lead is that it is appropriate in the lead for both terms to be there as written. I do think that the terms should be followed up into the main article. This is just an outsiders opinion of the comments being made. --CrohnieGal^Talk 12:40, 28 August 2008 (UTC)

I don't see a problem with saying "pseudoscience or quackery" in the lead as long as both terms are duly referenced. This doesn't prejudice whether most practicioners are fraudulent or just ignorant (as in Hanlon's razor), it simply means that the treatments have no verifiable effect. --dab (𒁳) 13:09, 28 August 2008 (UTC)

I support Verbal's suggestion to chop the sentence at the semicolon. Besides the tendentiousness of "quackery", there is another issue, the phrase "placebo therapy at best and quackery at worst". Homeopathy is placebo therapy; how could it be worse? Looie496 (talk) 16:49, 28 August 2008 (UTC)

There are some homeopaths who encourage their patients to avoid evidence-based treatments in favor of their homeopathic treatments. This is worse than placebo therapy in some ways. At least, that's what I gather from the source. ScienceApologist (talk) 16:52, 28 August 2008 (UTC)

I can think of quite a few who are anti-vaccination, for example. Brunton (talk) 17:39, 28 August 2008 (UTC)

Looie, according to your logic, there is no quackery, since all quackery (provided it doesn't outright poison you) will qualify as "placebo therapy" automatically. I really don't see the problem. Yes, "quackery" is "tendentious" -- but since it happens to be the actual tendency of academic mainstream, Wikipedia is positively required to follow suit. Failure to be tendentious in cases such as this would in fact violate the NPOV policy. --dab (𒁳) 09:32, 29 August 2008 (UTC)

So would someone like to add the quackery term and references to a suitable place in the text, as I don't want to edit regarding this as the originator of the thread. Note: I think at the current time that it should be mentioned in the body, and teh lead left as it is until further input is made for a good consensus. Verbal chat 09:41, 29 August 2008 (UTC)

Presumably it should go near the start of the "Medical and scientific analysis" section. Brunton (talk) 15:55, 29 August 2008 (UTC)

Sounds good to me. Please go ahead. Verbal chat 09:44, 31 August 2008 (UTC)

I've added it (basically just copied and pasted from the lead - references may need tidying up). Now that it's included in the body of the article, perhaps it would be appropriate to remove the passage "or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst."" from the lead? Brunton (talk) 12:09, 3 September 2008 (UTC)

Sounds good to me. Thanks. Verbal chat 14:04, 3 September 2008 (UTC)

I may be ariving late for the dance, but can not help addding my two cents. In the absence of notable, verifiable sources stating that "homeopathy is quackery", or "homeopathy is pseudoscience", then the article would have to avoid these pejoritive terms and go with more neutral terminology to describe the lack of scientific validation. If notable, verifiable sources that use pejoritive language are to be used, the authorship of these sources should always be included in the main text of the article to avoid the appearance that the article itself if calling homeopathy "quackery" or pseudoscience". Writing that "homeopathy has been labeled as pseudoscience" is not the best form. It is better to write : "Acording to Dr So-and-so of the instituite of such-and-such, homeopathy is a pseudoscience". This accomplishes three things: it lets Dr So-and-so take the fall for using the pejorative term. It also lets the reader of the article judge the notability for herself. Finally, it also makes it clear that this is the opinion or assesment of Dr So-and-so and maintains neutrality in the article itself.

Verbal is accurately trying to portray the magnitude of the opposition to homeopathy. If there are notables out there who say that 'homeopathy is unimpresive or unscientific' then that is one thing. If there are notables out there who say that 'homeopathy is outrageous, dangerous quackery' then the article needs to share that with the reader. The facts are that homeopathy has been met with such a hostile tone. It is the duty of the article to report this hostile tone in a neutral way. The most neutral way to do this is to clearly attribute such comments to their original authors. Naturstud (talk) 17:38, 6 September 2008 (UTC)

:Naturstud has a good point. Phrasing and wording can be tricky, but it can be done. Rather than using perjorative terms (unless there are good papers to support their use and the context is similar) then wording such as 'homeopathy currently does not enjoy the support of mainstream science or medicine' or 'Homeopathy is still considered experimental with a lack of evidence to support it's efficacy in treating X or Y". If there's studies investigating it then the end could suggest "studies are ongoing to determine the benefits, if any, of X for Y". Soyuz113 (talk) 18:18, 6 September 2008 (UTC) ^{(Edits of indef blocked user stricken.)}

User:Soyuz113 above is a probable sock of indef-blocked User:CorticoSpinal, see sockpuppet case --Enric Naval (talk) 17:40, 7 September 2008 (UTC)

Soyuz113 has "been blocked indefinitely from editing in accordance with Wikipedia's blocking policy for sockpuppetry, edit warring, disruption and block evasion." I have stricken his remarks, as striking or removal is customary in such situations. -- Fyslee / talk 06:13, 8 September 2008 (UTC)

Wikipedia does not make future predictions, per WP:CRYSTAL. Try some other formulation. BTW, it's spelled p-e-j-o-r-a-t-i-v-e. Skinwalker (talk) 19:17, 6 September 2008 (UTC)

The article says that homoeopathy is regarded as pseudoscience or quackery, and cites RS supporting that. Brunton (talk) 00:21, 7 September 2008 (UTC)

Actually my point was that it is not enough for the article to vaguely assert that "homeopathy is regarded as quackery" with a footnote but rather that a direct quote should be employed "Dr K. Joy describes homeopathy as 'quackery of the worst kind'". Direct quotes from notables are the best way of delivering pejorative characterizations. The best criticism on wiki, as in life, is specific criticism. Naturstud (talk) 14:19, 7 September 2008 (UTC)

That's particular attribution - an attempt to lessen the impact of a majority view by treating it as if it was held by only one proponent. Shoemaker's Holiday (talk) 17:27, 7 September 2008 (UTC)

Only if the hostile tone ('quackery') can be sourced as belonging to the majority. I have no use for homeopathy, and would suggest that the majority of my colleages are unimpressed by it. It is something else to claim that the majority of them are hostile towards it. I think the article can make the case that homeopathy is rejected by the majority of health care providers, but probably can not make the case that the majority of health care providers would resort to name calling/are outraged or hostile. Naturstud (talk) 15:47, 9 September 2008 (UTC)

In an environment where speaking the truth reverses the legal burden of proof, calling a quack a quack is simply a way to lose your shirt to lawyers working on spec. It's tough to prove the quack knows he's a quack. Hence few primary sources are completely unequivocal. It takes considerable courage.LeadSongDog (talk) 18:19, 9 September 2008 (UTC)

While this is taking us off-topic, in the USA you can call anyone a quack with impunity. Courts have made rulings on that matter and they don't take such things as being serious enough to violate a citizen's right to freedom of speech. Stephen Barrett, who is a highly recognized champion against health fraud and quackery, has been accused of being a quack many times by real quacks and their henchmen, and he can't do anything about it. They are protected by the law, and he is protected by the same law if and when (very rare) he calls them quacks. BTW, he doesn't normally ever do that. It is also not a requirement (or even reality) that a quack is conscious of any wrongdoing or of being a quack. Most quacks are likely truly believers in their ideas and methods. That doesn't relieve them from the obligation to refrain from making false claims, and from heeding warnings from scientists, scientific skeptics, authorities, etc.. They can and are still prosecuted for breaking laws against practicing medicine without a license and against false advertising. -- Fyslee / talk 04:02, 10 September 2008 (UTC)

←Both quackery and pseudoscience are well sourced, and consensus on them being in the article has been established. No policy is broken by these terms appearing in the way they do now. The subject of this discussion was to assess whether quackery should remain in the lead, or only appear in the article, and this discussion has lead to some improvement to the article. If you want to bring up new discussions, please do so in a new thread and check that they haven't recently been discussed in the archive. I'm trying to keep this discussion on topic and it's drifted off somewhat. Thanks. Verbal chat 16:01, September 9, 2008 (UTC)

I agree. If no rules are broken, then end of discussion. If "quackery" isn't mentioned in the body of the article, then do it and let's get on. Problem solved. -- Fyslee / talk 04:02, 10 September 2008 (UTC)

I've marked this as resolved as the points now appear in the body and there is no consensus for change at this time. Verbal chat 12:24, 11 September 2008 (UTC)

Meatpuppetry

A major objector to that wording has been evading his indef ban and contacting editors. If anyone has been contacted by an IP from Karnataka, Bangalore, India, don't cooperate with this indef banned user or you may be blocked for meatpuppetry.

See: http://en.wikipedia.org/wiki/Category:Suspected_Wikipedia_sockpuppets_of_Dr.Jhingaadey.

-- Fyslee / talk 04:02, 10 September 2008 (UTC)

Thanks for the warning

Thank youf or warnign us Smith Jones (talk) 18:59, 10 September 2008 (UTC)

POV tag

As there has been no activity again for a while, and as the article has been tagged in places where users feel citations are needed, I feel it is time to remove the POV tag from the article. If you feel there are still problems please tag individual sections or use the fact/check tags, etc, or start a new discussion on specific concerns below. Thanks Verbal chat 09:47, 26 September 2008 (UTC)

I have been absent for a while, so I it will take some time for me to evaluate the current state of the article. Let me just say that I would be quite surprised if the tag no longer applied, and I am not sure that the problems can be localised in this way to individual sections. If there is a consensus among the other editors to remove the tag, that's fine with me as long as this doesn't create a prejudice against my reinstating it after I have finished reading the article. Of course, I would like to be surprised. --Hans Adler (talk) 10:21, 26 September 2008 (UTC)

The problem is we have people saying no the tag must stay for many reason, but then not saying what those reasons are - or being so vague that nothing can be done. If you have new or unaddressed concerns, please add them here or start a new section so they can be fixed. Note that the lead has been extensively discussed, so I feel that individual sections should be tagged rather than the whole article. Good to have you back. I remember you mentioned a bad reference, but I couldn't find it at the time - maybe that still needs fixing. Verbal chat 10:30, 26 September 2008 (UTC)

I start rereading the article to see if it has improved and soon find that it hasn't. The second sentence, for example: Homeopathic practitioners maintain that an ill person can be treated using a substance that can produce, in a healthy person, symptoms similar to those of the illness.. A more neutral formulation might be Hahnemann's theory was that.... I expect that there is much more such deweaseling to be done but I'm not able to wade through the article now. Colonel Warden (talk) 11:09, 26 September 2008 (UTC)

I don't see a problem with that change, but I don't think the current version is inappropriately worded. It hardly justifies the tag. Verbal chat 11:18, 26 September 2008 (UTC)

It is an illustrative example. My general position is that the article has a tendentious tone which is not NPOV. As another simple example, we have a sentence soon after which has three citations. This is poor style and also adds to the tone by suggesting that the point needs hammering into the article. See Sun Tzu for a contrasting style which is perhaps our ideal. Note the restrained use of citations even though there is a "vigorous debate" upon some aspects of the topic. The stylistic effect is more detached and unemotional. Colonel Warden (talk) 11:47, 26 September 2008 (UTC)

The reason there are three citations is because of the consensus formed on this page that they were required, however I also have no problem in commenting two out and moving them to the body. If there is a tendentious tone please state exactly which parts you are unhappy with. There are also tone tags, rather than POV tags. So far the tag has not been justified. Verbal chat 11:55, 26 September 2008 (UTC)

Verbal, thanks for moving things in a very good direction (the middle). One thing that I still don't like in the lede is the quackery sentence. It seems to have a much better reference now than it used to (i.e. the absurd Nigerian article; I suspect nobody ever read more than the abstract, and it looked very dubious). Still I think a sentence of the form "[Convincing reason] has caused [subject] to be regarded as [invective]" is not NPOV. It doesn't just report the name-calling; in my eyes it embraces it. (Compare: "His remarkably disastrous impact on world history and the domestic economy has caused George W. Bush to be called a moron".) I don't want to start yet another fight over this sentence, but if you remove the global NPOV tag this sentence should be flagged. More if and when I get the time to reread the article. --Hans Adler (talk) 16:04, 26 September 2008 (UTC)

Without commenting on the tag, I agree the quackery mention in the lede is not a good choice. While that notion should be prudently fleshed out elsewhere in the article, let's remember that in addition to bunk, it also has a connotation of fraud. While clearly fraudulent use of HP happens, leaving that connotation in the lede suggests it is essentially synonymous with fraud, which is certainly not the case. Clarifying that nuance would be too much for the lede, so I strongly suggest dropping it from the lede. Baccyak4H (Yak!) 16:27, 26 September 2008 (UTC)

The article is moving towards neutrality, but is not there yet. Neutrality could be increased by use of direct attribution within the text whenever we are reporting opinion, especially controverisal ones. I have tried to raise this issue before. Anyone who says that homeopathy is 'quackery' is expressing a POV. I am fine with the article presenting such POVs if they are notable. I just think that our best NPOV interest is served by directly sourcing such POVs in the main text:

Dr Notable has said that "homeopathy is quackery". reads as much more neutral that the current:
...have caused homeopathy to be regarded as pseudoscience[14] or quackery.[15]

What we need are good solid quotes like "Homeopathy is a form of pseudoscience". The references [14] and [15] are actually rather weak. One of them is a second hand report (author unknown) stating that the committee for skeptical inquiry considers homeopathy to be a pseudoscience. The other is a link to an abstract written by an economist I guarantee you have never heard of...and he doesn't even come right out and say 'homeopathy is quackery'. The neutrality of this article will depend on the sourcing of direct quotes from notable entities. The more POV and controverisal the original quote, the more effort required by us to make it clear that this is a specific person's or group's POV, not ours. As it exists, we have some fudgy references standing behind two loaded POV terms. The pseudoscience/quackery line as it is written could be understood to mean: "Some people, many people, most people or two people regard homeopathy to be quackery/pseudoscience". The key to neutrality is clarity. The key to delivering criticism is to be specific. Naturstud (talk) 17:31, 26 September 2008 (UTC)

The mention of quackery in the lead was discussed above. Feel free to add to that discussion but for now I think that matter is closed. Maybe come back in a month or two with a proposal to change that section and see what happens (or a request for comment). To Naturestud, the claims are properly sourced and specific attribution in this case is misleading. Hans, thanks for the compliment and maybe we could work on a new wording along those lines - although it already seems to follow your example. Verbal chat 17:55, 26 September 2008 (UTC)

Just to clarify: I said it's not NPOV, i.e. it's not neutral point of view. As the Bush example shows, not attributing the invective to anyone in particular and simultaneously explaining the reasons for its use is an underhanded way of making it plain that we, as Wikipedia, agree with its use. Personally I would use the respective invective myself in one of the two cases, but I feel strongly that we have no right to make either statement when speaking for Wikipedia. --Hans Adler (talk) 19:54, 26 September 2008 (UTC)

Wikipedia doesn't agree with anything, and we don't speak for wikipedia when we edit, we just report what reliable sources say. We are not agreeing on the strength of the sources being used to report a certain fact. --Enric Naval (talk) 20:01, 26 September 2008 (UTC)

By accepting the source's opinions as 'certain fact', you are subscribing to that source's point of view. Neutrality is about presenting information, opinions and conclusions, not anylysing/judging them and presenting them as 'facts'. The only facts that we can present is that some specific authors hold the opinion that homeopathy is pseudoscience/quackery. The facts are that they wrote what they wrote. My POV (and I suspect yours) is that they were correct when they wrote it.Naturstud (talk) 20:37, 26 September 2008 (UTC)

I haven't looked at the new sources yet. The problem with this sentence is that it says very clearly, although implicitly, that we do agree with the sources. In a case like this (criticism of a subject in the article on the subject) we are not allowed to do this; the strength of the sources (almost) does not matter. --Hans Adler (talk) 20:08, 26 September 2008 (UTC)

I usualy agree with you Verbal, but not this time. The sources are weak, especially given the 'name calling' aspect of the terms involved. We need much stronger sources that would stand up to being inserted in the main body of the text. That is the acid test for a good source, after all. Would you be comfortable with the articke stating that "Ayo Wahlberg of the London School of Economics has written:

"Just as Roy Porter showed how the mid-19th century professionalization of medicine gave rise to a ‘quackery with a difference’ as a whole range of new medical movements—homoeopathy, hydropathy, medical botany, mesmerism—actively denounced allopathic or modern medicine, I will suggest that the late 20th century birth of ‘complementary and alternative medicine’ (CAM) has resulted in yet another transformation in quackery."

Are we really comfortable using this as our reference [14] for the statement "homeopathy...regarded as quackery"? Surely we can do better. Nothing is ever 'closed' on wiki, it seems. I would gladly support removing the neutrality tag should the article ever gain neutrality. By the way - I am an ND who will gladly put my POV on the record by saying that I think Homeopathy is both pseudoscience and quackery. You can quote me on that, but I am probably less notable than Ayo Wahlberg and Roy Porter combined. I just don't see the point of pretending that we have acheived neutrality. Let's beef up the refs first. Naturstud (talk) 18:10, 26 September 2008 (UTC)

Naturstud, the sources are four papers on four different papers (not sure if they are all peer-reviewed), being one social journal and three medicine journals, and one of the papers is authored by Edzard Ernst. We can't probably quote you until you have published first your views about homeopathy on a peer-reviewed journal.

None of the sources is claiming that they view homeopathy as quackery, they are plainly claiming that it ~~is quackery~~ ok, Erns says that it's regarded as quackery, and the papers are backing that with facts. Sorry, but that's not a POV, that's a conclusion by specialists on the field that have examined the facts. As for name-calling, that's just your opinion. --Enric Naval (talk) 19:28, 26 September 2008 (UTC)

You don't have to apologize Naval - but if you could provide actual quotes from these sources where they state 'homeopathy is pseudoscience/quackery', that would certainly help. My point is that it is not possible to do this with the two refs that I have discussed above. I am suggesting that to keep terms like 'quackery' and 'pseudoscience' in a neutral article, we should provide the best possible sources. In this case, a source that provides a direct quote is preferable to a source that must be sumarized or 'interpreted'.

On a second point, the conclusions that 'homeopathy is quackery' and 'homeopathy is psudoscience' (if this is indeed what the four references are claiming) is absolutely 100% POV. There is nothing wrong with calling it just that, and there is nothing wrong with representing notable, verifiable POVs in this wiki article. It just needs to be abundantly clear that such points of view belong to the original authors and are not a judgment being made by the article. Your claim that such conclusions are NPOV 'facts' because they are published in peer reviewed journals and are written by specialists takes us further away from neutrality, not closer to it. Let us be specific in reporting what was said by whom and let the reader judge. Naturstud (talk) 20:04, 26 September 2008 (UTC)

I corrected my comment above on the "is" --> "regarded" thing --Enric Naval (talk) 23:44, 26 September 2008 (UTC)

Can we just agree to disagree about this sentence, for the moment? In the end we may need an RFC on this, but in the meantime it's probably best to make good use of the current constructive spirit and improve the rest of the article. It shouldn't be too hard to agree on some kind of tag to mark this sentence with in the meantime. --Hans Adler (talk) 20:01, 26 September 2008 (UTC)

I agree that the sentence should stay, but disagree that it has been presented in an NPOV. I also think that the references for this line are too weak to support removing the neutrality tag at this point. Naturstud (talk) 20:08, 26 September 2008 (UTC)

How about the Ernst reference for "quackery at worst"? Verbal chat 21:56, 26 September 2008 (UTC)

Probably fine in the way we are currently using it, i.e. including the "placebo therapy at best" bit. I am insisting on this because of personal experience (homeopathic self-medication being very effective for my hayfever, which I already knew to be strongly susceptible to placebo), which suggests that placebo therapy can be a very good thing, and because enhancing the placebo affect is probably the one strong point of homeopathy. --Hans Adler (talk) 22:30, 26 September 2008 (UTC)

I like the Ersnt quote best for a few reasons:

His entire paper is availible (full, free text) so it is verifiable.
He presents his comments in a relevant context (an analytical discussion of efficacy)
He balances the q-word with the p-word, acknowleging that there may be some honest Homeopaths out there who are getting positive outcomes due to the placebo effect. The full quote: "It is in particular the use of highly diluted material that overtly flies in the face of science and has caused homeopathy to be regarded as placebo therapy at best and quackery at worst." The full quote makes his stong opinion clear. Truncating his quote or simply claiming that he thinks homeopathy is quackery makes hime seem more intolerant than he is.

Interestingly, in the line that follows, Ernst seems to be advising us directly on how to regain some neutrality: "Thus, the efficacy of homeopathic remedies has always been a matter of bitter controversy" (emphasis added). He acknowledges that Homeopathy is not merely controversial, but that people tend to get worked up about it. If Ernst can acknowledge his own biterness as a way of contextualizing his comments (the ref he provides is to his own review entitled 'The heresy of homeopathy'), I believe it behooves us to do the same.

I would like to see the 'name-calling' quotes put into such a context, something along the lines of..."The controversy surrounding Homeopathy is often heated and sometimes bitter, with some critics using terms like 'quackery'"...followed by full quotes that use such language.Naturstud (talk) 22:57, 26 September 2008 (UTC)

And those puntualizations are why why the article says "X and Y have caused homeopathy to be regarded as" instead of "homeopathy is" :D Also, Ernst is not "some critics" and he also uses "regarded" (which means that my comment above was wrong, ooops).

I think that you got the idea of NPOV wrong. If mainstream science thinks that homeopathy is quackery, then we report that. Time to use that new-fangled guideline on medical sources :) See Wikipedia:MEDRS#Cite_peer-reviewed_scientific_publications_and_check_community_consensus "Neutrality and no original research policies demand that we present the prevailing medical or scientific consensus". It's our duty to "balance" it or make it neutral to avoid stomping on the minority. It's quite the other way around "Although significant-minority views are welcome in Wikipedia, such views must be presented in the context of their acceptance by experts in the field." That means that if there is a minority view that homeopathy then *gasp* we must put them on the context of consensus on the field, which in this case would be considering that it doesn't work at all. NPOV is not about not making minority view holders feel good. Jimbo said something about how, if wikipedia wants to be respected, it has to use the scientific consensus and avoid fringe views from taking over... hum... I don't remember the exact cite, it was something like that :P I think is was extracted from here --Enric Naval (talk) 23:44, 26 September 2008 (UTC)

If mainstream science thought such a thing we would report it. But it doesn't. Some mainstream scientists hint that homeopathy may be quackery, or that it is regarded by some as such. That's not at all the same thing.

I don't know the exact reasons for this. Perhaps many scientists people feel it's not good for their career to criticise a therapy form with so many followers too openly and too vehemently. Perhaps many scientists keep quiet out of respect for friends and relations who believe in homeopathy. (Such as the 19th century physician who got in trouble for cooperating with a homeopath who was his wife.) Or perhaps they feel that homeopathy may be an effective placebo therapy, and that it's best for patients not to try to break the spell by saying it's only placebo (or worse). But fact is, we don't have the sources to back up your claim. --Hans Adler (talk) 00:15, 27 September 2008 (UTC)

We won't get all scientists to say anything. That's an absurd idea. And to sources, I've done a brief look on Google Scholar and found at least a couple a couple that don't hint, they state it outright. And there's a this one from Nature stating that it's pseudoscience. 24.76.161.28 (talk) 00:34, 27 September 2008 (UTC)

To be fair, we are talking of sources that talk about "quackery", so the nature one doesn't count. Your first source is Ernst's paper. Your second source is a meta-review and cites only two papers that talk about quackery, one of them is Ersnt paper, and the other one says that, if we don't abandon the statements made by traditional medicine when tests yield negative results, then we risk supporting quackery. --Enric Naval (talk) 01:10, 27 September 2008 (UTC)

Apart from quackery in the lead...

Leaving the quackery aside, any other comments/discussions? If it's something big please start a new section but please be specific. Thanks! Verbal chat 21:56, 26 September 2008 (UTC)

Currently only the thing you seem to be afraid of. --Hans Adler (talk) 22:30, 26 September 2008 (UTC)

It's true, I don't like ducks - but this is off topic :) The quackery conversation can continue above, my intention was to keep it contained ... Verbal chat 22:33, 26 September 2008 (UTC)

I meant the other one, from the other forum, actually. But let's keep it off the table for the moment. --Hans Adler (talk) 23:17, 26 September 2008 (UTC)

Moving on a little in the lede, we have scare quotes for the word remedy which won't do. Then it says "The end product is often so diluted that it is indistinguishable from pure water, sugar or alcohol." If we want to get into this here, then it needs reworking to provide better context and also to avoid confusion about the diluent. The context is the Principle of Least Action and similar ideas which should be presented first. Colonel Warden (talk) 23:51, 26 September 2008 (UTC)

How is the Principle of Least Action immediately relevant? We could get into an enormous discussion about physics, or we could state that the molecular concentration makes it chemically indistinguishable. Or leave the current wording. 24.76.161.28 (talk) 00:41, 27 September 2008 (UTC)

The article is supposed to be describing Homeopathy. As I understand it there are several reasons behind the dilution. One is the idea of avoiding the toxic effect of the ingredient and we say something of this. Another is the idea is that you want the smallest effective dose because this will have the best effect. A third aspect seems to be the idea that the process of dilution and succussion amplifies the effect and that's why it is often repeated to an absurd level. The latter idea is the wacky bit that the article keeps coming back to again and again because it is such a soft target but it is not fundamental to homeopathy. This idea was controversial within homeopathy itself and we should say something of this. See this history, for example. My point is that the lede is so eager to tell us that high dilutions may leave nothing of the original ingredient that it neglects to explain properly how and why some homeopaths came to do this. It is neither informative nor NPOV. Colonel Warden (talk) 08:34, 27 September 2008 (UTC)

I think most homeopaths would consider succussion pretty fundamental to homeopathy, as it is their last refuge at a pseudoexplanation for why there might be a difference between two identical dilutions that are claimed to be different - one of them was succussed and thereby imparted a healing quality to the "remedy". -- Fyslee / talk 16:49, 27 September 2008 (UTC)

The terms and principles of succussion or potentization are not mentioned in the lede - there is just a vague refernce to shaking in the sentence in question. If they are fundamental, as you suggest, then the lede should do more to explain them. This is my point - we have criticism without context. Colonel Warden (talk) 18:36, 27 September 2008 (UTC)

If they are important and are mentioned in the body of the article, then they deserve short mention in the lead, per WP:LEAD. If you have a good way of doing this, please start a new section, make a trial version, and let's develop it into a good consensus version that can be included in the lead. That way we can avoid edit warring over this. This really needs to be done, and I'm surprised it hasn't been mentioned in the lead. -- Fyslee / talk 21:29, 27 September 2008 (UTC)

More generally, I browsed several works in my local library today - a general encyclopedia, a survey of alternative medicine by the Consumers' Association, a book about homeopathy by a practitioner and an exposé. The latter had an overt agenda of attacking alternative medicine and our article most resembles it rather than the other works. This point has been made before but needs restating: we should be aiming for an article which stands comparison with other encylopaedic treatments, not with works of advocacy. Colonel Warden (talk) 18:36, 27 September 2008 (UTC)

"Advocacy" works both ways. NPOV requires total coverage of the subject from all possible angles found in V & RS. WEIGHT reguires that the mainstream scientific POV be dominant in the article, without supplanting a proper presentation of the homeopathic POV. The scientific POV will often be described as factual because it is backed by good research and unquestioned facts (which are only questioned by fringe sources, which get little weight here or elsewhere). Stating facts as facts is not advocacy, while stating undocumented fringe claims as facts is advocacy, and that is forbidden here. The homeopathic POV must not be presented as if it is legitimate or describes the "truth" of ideas not confirmed by mainstream science. Without such evidence, homeopathic claims are identified as claims. The homeopathic POV should just be described neutrally and factually, without a shadow of advocacy. If scientific evidence ever supports current claims, then the V & RS will show that and the article will be revised accordingly. -- Fyslee / talk 21:29, 27 September 2008 (UTC)

As fyslee says. --Enric Naval (talk) 13:00, 28 September 2008 (UTC)

New section Homeopathy#Exemption for homeopathy

In my opinion this new section is completely pointless and a case of undue weight. There is no discernible connection between the part about the "appeal to nature fallacy" and non-testing of homeopathic placebos for side-effects. The second paragraph is US-centric, despite the fact that homeopathy is far more popular in the EU and some other countries than it is in the US. Its reference is a popular article, so unlikely to give the complete picture; my educated guess is that FDA regulations are really very similar to the corresponding EU regulations, which would mean that the exception only holds for extremely diluted remedies.

Thus we have an entire section about the following two legitimate bits of information: Extremely diluted homeopathical remedies are not tested for side-effects, which makes perfect sense if they are placebos (since the testing would be in a placebo-controlled study) but would be problematic if they had a non-placebo effect. And they are allowed to contain more alcohol (so what?). In my opinion this section is completely unencyclopedic. --Hans Adler (talk) 07:51, 27 September 2008 (UTC)

I agree that it is too parochial and the term normal thinking is a giant weasel. India, for example, seems to favour homeopathy and so, if we were to count heads, we might come to a different conclusion about "normality". I suggest that this section be merged with the following section on Regulation and Prevalance and that there be sub-sections which detail the position in each major region: USA, EU, India, etc. Colonel Warden (talk) 09:17, 27 September 2008 (UTC)

Moreover, per the general restrictions on this topic and since this section seems to have been added without talk or consensus, it should come out pending further discussion. Colonel Warden (talk) 09:49, 27 September 2008 (UTC)

I think parts of this section could be worked into the 20th Century section, but I agree that this form isn't ideal. Verbal chat 10:48, 27 September 2008 (UTC)

I basically agree with Colonel Warden and Verbal. I copied the section from a Safety section elswhere here, but was aware that it would need tweaking or a slightly better placement, but was called away and didn't have the time to do it immediately. This discussion is therefore appropriate. My edit was an example of WP:BRD and I certainly won't edit war over it by reinstating it without discussion here. The information is useful but needs to be merged properly. It contains information of which many people are likely unaware and which is missing from the article, thus it improves the article's full coverage of the subject. The high alcohol content presents a potential danger for some users, especially recovering alcoholics and children, and thus the alcohol content matter needs to be noted. The FDA is a reliable source and the history of FDA regulations of homeopathy is quite interesting, since it is an example of how political pressures and manipulation of laws by politicians who are supporters of homeopathy have affected those laws, in spite of any scientific factors. FDA regulations, just like many other things that happen in the USA, are copied elsewhere and influence what happens in the rest of the world, whether we like it or not. Let's discuss how this can be merged, rather than just deleting it. Does this sound reasonable? -- Fyslee / talk 16:42, 27 September 2008 (UTC)

Thanks for the explanation. I think this topic really belongs into Regulation and prevalence of homeopathy. Regulation and prevalence of homeopathy#United States is already quite comprehensive but does not cover the bit about not testing for side-effects – perhaps because others agree that not testing a placebo for side-effects is not a big deal. I will try to find the original FDA regulations to see whether, like those in the EU, they only apply to highly diluted remedies (1/10000 for most substances, but there is a clause for things like digitalis and curare as well). Of course, if digitalis D1 were legal according to FDA regulations, that would be worth mentioning in the main article; but I doubt it.

I didn't know there are FDA rules about the alcohol content of medicine. I guess there are exceptions for various special cases, since it would be crass overregulation otherwise. I don't think this exemption is sufficiently notable to mention it in the main article, but of course the high alcohol content is worth mentioning under safety issues.

Regulation and prevalence of homeopathy#European Union currently mentions not testing for efficacy. I don't know if the technical term "efficacy" includes side-effects, but so far as I know there is no testing for side-effects and this should be mentioned clearly. I will verify this from the original regulation text before editing the section accordingly. --Hans Adler (talk) 17:07, 27 September 2008 (UTC)

Sounds good. Bring what you find here and we can hammer this out into an acceptable consensus version for inclusion. -- Fyslee / talk 17:36, 27 September 2008 (UTC)

OK, for the EU the question of testing for safety / side-effects seems to be a matter of national legislation. E.g. in Finland see section "Safety and Efficacy" of [15]. This spells out further conditions for practically testing the condition "to guarantee the safety of the product" from the following passage in the EU directive: "there is a sufficient degree of dilution to guarantee the safety of the medicinal product; in particular, the medicinal product may not contain either more than one part per 10000 of the mother tincture or more than 1/100th of the smallest dose used in allopathy with regard to active substances whose presence in an allopathic medicinal product results in the obligation to submit a doctor's prescription". The Finnish rules are not as strict as those for normal medicine, and they are certainly a lot cheaper for the manufacturers, but I think they make sense. I don't think we need to mention these details. (Research and sourcing for various European countries would be quite messy, anyway.) I'll look at the FDA regulations now. --Hans Adler (talk) 17:57, 27 September 2008 (UTC)

I feel with you about making potentially messy and complicated additions! One way to deal with it would be to make a short statement, for example "Regulations regarding testing for safety and efficacy vary between countries."[add the refs here]. Then include the links and short, relevant phrases and place them in the references, leaving the body of the article free from a messy clutter. Some people love to read all the gory details, and they will be thankful for the links in the refs, while many if not most will never get that far, but will still have learned something from that one sentence. Does that sound like a good solution? It would be a shame for your hard work to get wasted. Share it with the world in this way! -- Fyslee / talk 20:43, 27 September 2008 (UTC)

I don't think I can source this particular formulation (as far as as efficacy is concerned it's not even true), but the principle is good. Thanks for the suggestion. --Hans Adler (talk) 20:52, 27 September 2008 (UTC)

I am still reading about the US situation, but one thing is clear: It's very different from the EU situation. In the EU, to be registered according to the homeopathy exemption, homeopathic remedies must not come with a "specific therapeutic indication". In the US there seems to be no registration (I am amazed), and homeopathic OTC remedies must "bear at least one major OTC indication for use" (and too vague or general indications are regarded as a problem). The EU is very obviously not copying the US here. --Hans Adler (talk) 20:47, 27 September 2008 (UTC)

Very interesting. I know that in Denmark the laws regarding "natural" medicines and dietary supplements are different from pharmaceuticals, with a sliding scale of requirements regarding evidence and claims. "Natural" medicines must have at least one form of research indicating some benefit, and are allowed to make certain health claims. The research might be crap that is totally discredited elsewhere, but that's the way it is. Supplements are those things that can't even make it that far, or have actually been tested while attempting to become registered for sale as mainstream pharmaceuticals and found lacking and/or dangerous. They can still be sold as supplements, which can mean it's a crap shoot when taking them. They may actually have been proven to be dangerous, so the manufacturer just ceases attempting to get them sold as pharmaceuticals or natural medicines. So supplements are potentially the most dangerous category, even more dangerous than tested pharmaceuticals that have proven benefits and properly documented side effects. It's an odd situation, but the politicians have made this big loophole designed for the manufacturers of supplements, and they willingly jump through it and exploit it. -- Fyslee / talk 21:00, 27 September 2008 (UTC)

Yes, I believe the food supplement problem is the same in Germany, and the "natural" medicines are regulated in the same EU directives that we are already citing for homeopathy. (Actually I think these rules do make some sense. It's plausible that medicine with a long history of use often comes with an unusually strong placebo effect. And we really don't want placebo-controlled studies for genuine food, so I suppose the loophole isn't easy to close.) Btw, I must correct myself: Homeopathic remedies in the US must be registered, after all. The magic word for finding information about this is National Drug Code System. --Hans Adler (talk) 21:33, 27 September 2008 (UTC)

Surprisingly, I couldn't find any minimal dilution conditions for homeopathic remedies in the US. This doesn't necessarily mean they don't exist, as illustrated by my initial error concerning registration. If it's true that they don't exist, then there is a potential loophole here for everything in the Homoeopathic Pharmacopoeia of the US (and potentially for other traditional homeopathic remedies, although I think that's unlikely to be a problem). Thus the FDA would be relying on the good sense of the Homoeopathic Pharmacopoeia Convention of the US for the safety of homeopathic remedies, rather than on studies or prescribed minimal dilutions, and there would be a potential danger here that would go beyond the "natural" medicines exemption in the EU. So that's something I would really like to verify. --Hans Adler (talk) 22:11, 27 September 2008 (UTC)

That loophole is already being exploited quite a bit. Various undocumented products that have nothing to do with homeopathy are being marketed with claims of being homeopathic, and thus they are flying under the radar of the FDA. Claiming to be homeopathic means they don't get investigated until many complaints or some registered injuries or deaths are recorded. Many of these products have very real quantities of active ingredients in them, so the claims of being homeopathic are bogus and misleading. Zicam [16] and HeadOn come to mind. Come to think of it, maybe HeadOn is a bad example here. -- Fyslee / talk 22:30, 27 September 2008 (UTC)

(ec) I see. Looks like the US has the following problem. Since indications are allowed (even required), and since the homeopathic pharmacopoeia doesn't effectively restrict them, it's easy to make a lot of money with products like your two examples. Any problematic potencies that appear in the pharmacopoeia has the potential to be mass produced without any clinical tests, like your first example. – If that's correct, I am sure the problem has been described before, so that we can do so too without committing synthesis. --Hans Adler (talk) 22:46, 27 September 2008 (UTC)

It's the place to make the most money with little investment other than marketing and shipping costs. -- Fyslee / talk 22:59, 27 September 2008 (UTC)

Research sources

You may find these to be interesting sources for your research:

Conditions Under Which Homeopathic Drugs May be Marketed - FDA
Homeowatch, especially the "Legal and Regulatory Matters" section. Note the references in the various articles.
An Alternative Perspective: Homeopathic Drugs, Royal Copeland, and Federal Drug Regulation - Suzanne White Junod, Ph.D. (From Food and Drug Law Journal 55:161-183, 2001)
Homeopathy: The Ultimate Fake - Stephen Barrett, M.D. (especially the U.S. News & World Report story about "the $20-million duck.") See the references.
Search of FDA website

-- Fyslee / talk 22:43, 27 September 2008 (UTC)

References

^ Whalley B, Hyland ME, Kirsch I (2008). "Consistency of the placebo effect". J Psychosom Res. 64 (5): 537–41. doi:10.1016/j.jpsychores.2007.11.007. PMID 18440407. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

[pmid18440407-1] Whalley B, Hyland ME, Kirsch I (2008). "Consistency of the placebo effect". J Psychosom Res. 64 (5): 537–41. doi:10.1016/j.jpsychores.2007.11.007. PMID 18440407. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

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