
Homeopathy (also spelled homœopathy or homoeopathy), from the Greek language words ''homoios'' (similar) and ''pathos'' (suffering), is a system of alternative medicine, notable for its controversial practice of prescribing water-based solutions that do not contain chemically active ingredients. The theory of homeopathy was developed by the Saxony physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but neither its empirical nor its theoretical foundation meets the minimum criteria of the scientific establishment. Homeopathy calls for treating "like with like" (law of similars). The practitioner considers the totality of symptoms of a given case. He or she then chooses a remedy that has been reported in a homeopathic proving to produce a similar set of symptoms in healthy subjects. This remedy is usually given in extremely low concentrations prepared according to a procedure known as potentisation, because it is held that this process gives higher dilutions more therapeutic power. == Basic principles == === Theory of disease === The conventional theory of disease in Hahnemann's time was based on the four humours. Mainstream medicine in those days focused on restoring the balance in the humours and thus the vital force by either removing an excess of a particular humour (through such things as bloodletting and purging, the use of laxatives, enemas and nauseous substances that made patients vomit) or by suppressing symptoms associated with the humour(s) causing troubles, for instance giving patients substances associated with cold and dry if the patient was hot and wet (e.g. feverish). The late 18th century was a time of intense exploration, and many new diseases were being identified. The model of internal humors was proving to be inadequate. For example, many new diseases were clearly associated with certain geographic locations, which was difficult to explain through totally internal mechanisms like humours. Instead, more scientists were considering a model of external causes. One variation was the idea of independent outside agents in the air, known as ''miasms'' or simply "bad airs". For example, malaria was thought to be caused by the bad airs found in southern swamps and jungles, explaining why it struck down people travelling in those areas. Hahnemann's idea was that by suppressing or going against the humours, doctors were sabotaging the body's own efforts to heal itself. He considered symptoms to be the way the body fought disease; for example, fever was its attempt to make itself warmer to fight whatever was ailing it. Unlike the humour-based logic, which would attempt to cool the feverish patient, Hahnemann felt that if the body wanted to be warm, making it warmer would be the proper solution. From this he developed the expression of the "like-cures-like" principle. Scientific medicine has discarded both the theory of the four humours and the theory of miasms (and similar ideas of that time), in favour of the germ theory of disease as part of a physiological model, based on the work of scientists like Louis Pasteur, Alexander Fleming, and Joseph Lister. Beginning with his early work, Hahnemann rejected the prevailing physical model, in favour of seeing disease as more dynamic (spirit-like). He considered the spirituality factors as the root cause of all disease, what he termed the "highest disease." Most later homeopaths, in particular James Tyler Kent, have tended to put even more emphasis on spiritual factors. Vitalism was more or less a part of mainstream science through the 18th century. Whereas modern medicine sees bacterium and viruses as Koch's postulates, some modern homeopaths regard them as effects, not causes, of disease. Others have to some extent adapted to the views of modern medicine by referring to disturbances in and stimulation of the immune system, rather than the vital force. In accordance with this view of disease, classical homeopathic treatment requires an interview, known as "anamnesis", which may take an hour or more, to determine the totality of the patient's symptoms. Hahnemann stated that a person could have more than one disease at a time, each of which might be contributing to the symptom picture of the patient. Hahnemann's approach was that the practitioner should first seek to treat the constant nature diseases, as these can more readily be identified in most cases (by cause, e.g. Arnica for contusion disease) and since they are fixed in nature, they are always treated with the same medicine, thus simplifying treatment. The homeopathic approach to the remaining pathic diseases could then more easily be used. Although modern homeopaths sometimes suggest that their art is especially effective against chronic diseases, Hahnemann himself recognized that homeopathy, like conventional medicine, has more difficulty with these than with acute sicknesses. In response, he developed his theory of miasms, which are supposed to cause all chronic disease (apart from that due to orthodox medicine or to faulty living habits). Hahnemann identified three types of miasm: syphilitic, sycotic, and psoric. Rajan Sankaran have extended this list. Constantine Hering developed the psora doctrine by propounding that symptoms developed in a particular way: * from less vital to more vital organs * from the surface to the interior * from the extremities to the upper part of the body As the patient is cured, the symptoms are said to be relieved (or to temporarily reappear) in the opposite order. === The law of similars === The first and most important "natural law" expressed by Hahnemann, the one from which homeopathy derives its name, is ''similia similibus curentur''—let like cure like. This means that the appropriate substance to treat a disease is one which induces similar symptoms in a healthy person. Homeopathy uses a wide variety of animal, plant, and inorganic substances, from sodium chloride (a.k.a. table salt) to ''lachesis muta'' (the venom of the bushmaster snake). What symptoms are associated with various substances is determined by homeopathic proving, in which the researcher imbibes the remedy and records all physical, mental, emotional and modal symptoms experienced. A homeopathic repertory is a listing of remedies by symptom, used to determine the most appropriate remedy for a given case. Hahnemann's finding are recorded in Materia Medica Pura. James Tyler Kent Repertory (published 1905) lists about 700 remedies. Today, nearly 3000 remedies are used in homeopathy, of which approximately 150 are considered common. Other homeopaths during and after Hahnemann's time, notably Hering and Lux, further developed remedies such nosodes, which are homeopathic dilutions of the agent or the product of the disease in question. Rabies nosode, for example, is made by potentizing the saliva of a rabid dog. Although Hahnemann himself did not treat for the constitution, using it as a basis for assessing the patient's vitality, later homeopaths, notably from Kent onwards, developed an approach to treatment, trying to get at the essence of a case (often referred to as "essence prescribing) called constitutional prescribing and which focusses on the mental-emotional and physical generals of a case. If symptoms become worse after starting a homeopathic treatment, this is referred to as an aggravation or healing crisis depending on when it occurs. When it occurs in the first few seconds or minutes of ingestion of the remedy, this is considered to be an "homeopathic aggravation," and generally occurs in acute cases or if the dose is too large. The idea of aggravation can be considered a consequence of the law of similars in that the medication initially adds to the symptoms of the disease and only gradually replaces it. If it occurs later, usually within 7-14 days of the remedy in chronic cases, this is considered to be a healing reaction of the body and a sign that the medication is taking effect. In some cases an aggravation does not occur but the symptoms improve immediately or after some time. It is also possible that the symptoms change or old symptoms reappear. Alternatively, the symptoms may be considered a response to the disease by the immune system, which is stimulated by the medication to overcome the damage created by the disease destroyed by the similar medicine. The law of similars is a guiding principle in homeopathy, but calling it a "law" is perhaps misleading. There is no certain way to determine an effective remedy for a patient, and homeopaths will often disagree on the best one in any given case. The homeopath will not use ''all'' the symptoms of a patient, but will decide which are the most ''characterictic''. Even then, there will be hundreds of entries in the repertory with most of these symptoms, and every entry will have symptoms listed that the patient does not exhibit. The lack of definite predictions by the law of similars makes it difficult to test scientifically. There are certainly many apparent counterexamples: aspirin does not produce headaches in healthy people, decongestants do not cause congestion, and penicillin does not cause fever. Nevertheless, some homeopathy advocates have suggested a certain plausibility in cases where the symptom is an adaptive immune response. For example, it is generally accepted that fever or inflammation are induced by the immune system in an attempt to eradicate pathogens, rather than being caused directly by the pathogen. One homeopath (Dana Ullman, MPH) argues that a substance that induces a particular symptom (such as fever), might do so by directly inducing or stimulating that specific immune system response. Such an enhanced immune response could aid the body in fighting disease. However it is also possible that a substance might induce a symptom by causing damage to the body in the same way that a pathogen does; and sometimes an immune response can itself cause damage (for example anaphylaxis). For these reasons, ingesting a substance to induce an immune response could be dangerous. ''See also'': List of common homeopathic remedies === The theory of infinitesimals === The most characteristic—and controversial—principle of homeopathy is that the potency of a remedy can be enhanced (and side effects diminished) by dilution in a particular procedure known as dynamization or potentization. Liquids are successively diluted (with water or occasionally alcohol) and shaken by 10 hard strikes against an elastic body, a process called succussion. Insoluble solids are diluted by grinding them with lactose, a process known as trituration. Homeopathic practitioners believe the vigorous agitation following each dilution transfers some of the "essential property" of the substance to the water, which fits in with the concept of disease as a disturbance in the "vital force" of the patient. The dilution factor at each stage is traditionally 1:10 (D or X potencies) or 1:100 (C potencies). Hahnemann advocated the use of 30C dilutions for most purposes, i.e. dilution by a factor of 10030 = 1060. Some later homeopaths, in particular Kent, have advocated the use of much higher potencies, which can no longer be practically achieved by the traditional method, but require succussion without dilution (Jenichen), much higher dilution factors (LM potencies dilute by 1:50,000 at each stage), or machines which in some way integrate dilution and succussion into a continuous process (Kent). Higher dilutions are generally considered stronger. This is in contrast to conventional medicine and biochemistry, which hold that the effects of a substance are always due to its physical and biochemical activity in the patient's body, and therefore that generally the more of an active ingredient is present in a drug, the more effect (whether positive, negative, or both) it will have. The choice of potency will depend on a number of factors depending on the homeopath. These can range from how deep seated the disease seems to be to how the patient has reacted to previous remedies. As a general (although not exclusive) rule, European homeopaths will use lower potencies than their United States counterparts. Some homeopaths believe that, while lower dilutions may have more of a physiological effect, higher dilutions may have a greater effect on the mental or emotional plane. Some homeopaths have suggested that hormesis, whereby a substance harmful at high doses can become beneficial at low doses, provides a rationale for the Law of Infinitesimals. However such a mechanism could operate only at low dilution factors, and provides no rationale for higher dilutions where no molecules of the original substance remain. == The practice of homeopathy == === History === Hahnemann began developing the homeopathic method after coming upon the idea that "like cures like" while translating a work on malaria. Upon reaching a passage stating that quinine was an effective treatment because it was bitter and astringent, Hahnemann felt this implausible because there were many other substances that were equally bitter yet lacked any therapeutic value. To better understand the effects of quinine, he decided to take it himself and observed that his reactions were similar to the symptoms of the disease it was used to treat. This was the birth of the homeopathic principle and is known as "The First Proving". Hahnemann and his students approached their treatments in a holistic way, meaning that the whole of the body and spirit becomes the focus of therapy, not just the localised disease. Hahnemann himself spent extended periods of time with his patients, asking them questions that dealt not only with their particular symptoms or illness, but also with the details of their daily lives. It is also suggested that the gentle approach of homeopathy was a reaction to the violent forms of heroic medicine common at the time, which included techniques such as bleeding as a matter of course. Homeopathy was brought to America in 1825 and rapidly gained in popularity, partly due to the fact that the excesses of conventional medicine were especially extreme there, and partly due to the efforts of Constantine Hering. Hering developed the psora doctrine by propounding that symptoms always move in a particular way: from the surface to the interior, from the extremities to the upper part of the body, and from less vital to more vital organs. His "Laws of Cure" state that the cure must take place in the reverse order of the appearance of the symptoms (first in, last out). Homeopathy reached its peak of popularity in America in the decades 1865–1885 and thereafter declined due to a combination of the recognition by the establishment of the dangers of large doses of drugs and bleeding and dissent between different schools of homeopathy. Nearly as important as Hahnemann himself to the development and popularization of homeopathy was the American physician James Tyler Kent (1849 – 1921). His most important contribution may be his repertory, which is still widely used today. Kent's approach to homeopathy was decidedly authoritarian and unscientific, emphasizing the metaphysical aspects of Hahnemann's teachings, in particular * insistence on the doctrines of miasm and vitalism, * rejection of modern scientific and pathological knowledge as a guide to prescribing, * emphasis on psychological symptoms in prescribing, and * insistence on the use of very high potencies. Kent's influence in America was somewhat limited, but his ideas were reimported into the United Kingdom, where they became the homeopathic orthodoxy by the end of the First World War. In the 1930s the popularity of homeopathy began to wane, especially in Europe and the United States, partly due to advances in biology and conventional medicine and partly due to a decline in coherence in the homeopathic community. Homeopathy experienced a renaissance in the 1970s that continues to this day. George Vithoulkas, who studied in India, where the homeopathic tradition had remained strong, was instrumental in resurrecting homeopathy in Europe, but this phenomenon must also be seen as part of a general increase in interest in alternative medicine. The ease with which large databases can be manipulated has brought about profound changes in the way homeopathy is practised. Today many homeopaths use personal computers to sift through hundreds of thousands of pages of provings and case studies. Because the information about lesser known remedies is more accessible, it is now more common for homeopaths to prescribe them, which in turn has lead to an increase in the number of new provings. Database technology has also encouraged researchers to reorganize and restructure existing information. For example, Rajan Sankaran has been very influential in placing the use of mineral remedies within the context of the periodic table. ''See also:'' List of important homeopaths === Homeopathy around the world === There are estimated to be over 100,000 physicians practising homeopathy world wide, with an estimated 500 million people receiving treatment. Over twelve thousand medical doctors and licensed health care practitioners administer homeopathic treatment in the United Kingdom, France, and Germany. Since 2001 homeopathy is regulated in the European Union by Directive 2001/83/EC. The latest amendments to this directive make it compulsory for all member states to implement a special registration procedure for homeopathic drugs. In the United Kingdom, as in most countries, homeopathic remedies may be sold over the counter. The UK has five homeopathic hospitals where treatment, funded by the National Health Service, can be obtained. Homeopathy enjoys more official recognition in the United Kingdom than in any other country, largely due to a tradition of royal patronage. The only other countries that come close in this respect are India and Pakistan. Homeopathy has been used in India since the middle of the 19th century and is today a widely practised and officially recognized system of medicine there. India has the largest homeopathic infrastructure in the world in terms of manpower, institutions and drug manufacturing industry. There are 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals. In the United States, homeopathic remedies are, like all healthcare products, subject to regulation by the Food and Drug Administration. However, the FDA accords homeopathic remedies a treatment significantly different from that accorded to other drugs. Homeopathic products are not required to be approved by the FDA prior to sale, not required to be proven either safe or effective prior to being sold, not required to be labeled with an expiration date, and not required to undergo finished product testing to verify contents and strength. Homeopathic remedies have their own imprints that, unlike conventional drugs, do not have to identify their active ingredients on the grounds that they have few or no active ingredients. In the United States only homeopathic medicines that claim to treat self-limiting conditions may be sold over the counter, while homeopathic medicines that claim to treat a serious disease can be sold only by prescription. Neither the American Medical Association nor the American Academy of Pediatrics has an official policy for or against homeopathy. Homeopathy's popularity in the United States is growing. The 1995 retail sales of homeopathic medicines in the United States were estimated at $201 million and growing at a rate of 20 percent a year, according to the American Homeopathic Pharmaceutical Association. The number of homeopathic practitioners in the United States has increased from fewer than 200 in the 1970s to approximately 3,000 in 1996. In Germany, about 6,000 physicians specialize in homeopathy. In 1978 homeopathy, along with Anthroposophy and herbalism, were recognized as "special forms of therapy", meaning that their medications are freed from the usual requirement of proving efficacy. Since January 1, 2004 homeopathic medications, albeit with some exceptions, are no longer covered by the country's public health insurance. Most private health insurers continue to cover homeopathy. In Austria homeopathy has been a recognized part of the medical system since 1983. In Switzerland homeopathy is one of the five classes of complementary medicine. At one time, homeopathic medications were covered by the basic health insurance system, as long as they were prescribed by a physician. This practice ended in June 2005. In Mexico the Instituto Politécnico Nacional (IPN) has a school of Homeopaty since 1936. This school has both bachelor and master degrees. === Diversity === There is, and always has been, considerable diversity in the theory and practice of homeopathy. The major distinction may be between what can be called the pragmatic and the mystical approach, but it should be remembered that there are not two distinct groups, but a spectrum of attitudes and practices. An early advocate of pragmatism was Richard Hughes, while the most influential mystic was James Tyler Kent. The pragmatists tend to be open to "whatever works", whereas the mystics tend to rely on the research of one or more authorities. There is still considerable diversity in both camps because the pragmatists usually define "working" based on personal experience and the mystics use various sources as authorities. The pragmatists tend to see homeopathy as ''complementary'' medicine and are more willing to co-exist with conventional doctors. Many in fact ''are'' conventional doctors. The mystics, some of whom are also conventional doctors, see homeopathy as ''alternative'' medicine and have more confidence that homeopathy can be used effectively against all diseases, with the caveat that many potential remedies have not yet been proven. The pragmatists are more likely to be interested in proving homeopathy in the framework of mainstream science. They will talk about the "memory of water" and stimulation of the immune system. The mystics see less need to justify their methods with conventional criteria. For them, homeopathy acts on a vital force that is, so far, not accessible to science. The pragmatists are more likely to prescribe (relatively) low dilutions in multiple doses, and sometimes use more than one remedy at a time. The mystics often use higher dilutions, but generally prefer a single remedy and sometimes a single dose. In the extreme form, pragmatists will even accept over-the-counter homeopathic remedies, but the mystics will always insist on an individual prescription. The mystics may see themselves as "classical" homeopaths, although the historical accuracy of the term may be questionable. The pragmatists see themselves as "scientific", even though they are not accepted by the scientific establishment. == The appeal of homeopathy == === Clinical Efficacy === Homeopathy is popular among patients and practitioners for several reasons. The most important is that patients have personally found it to be effective or heard from friends, colleagues, and the press of many cases, some of them spectacular, in which a sickness was healed after a homeopathic treatment. Some reinforce their favorable judgement with selective reference to positive scientific reports. Though they are aware that science has found no adequate explanation for the mechanism of homeopathy, they tend to subsrcibe to an empirical view of the matter: whatever works is good enough for them. This pragmatic attitude arguably characterizes most health consumers nowadays, whose main concern is for clinical efficacy rather than scientific sanction of their treatment choice. === Disaffection with the establishment === Another reason that many people embrace homeopathy is that they reject the medical establishment, which is perceived to place too much emphasis on machines and chemicals and to treat the disease, not the person. Homeopathic practitioners do, in fact, often spend much more time dealing with their patients than do conventional practitioners. Furthermore, homeopathic preparations have few if any side effects and are generally much cheaper than conventional medications. == The skeptical view of homeopathy == === Lack of a mechanism === Many scientific skepticism consider homeopathy to be a pseudoscience remnant from the age of alchemy. Others consider the belief in homeopathy to be a form of magical thinking. In fact homeopathy was developed at a time when many of the most important concepts of modern chemistry and biology, such as molecules and germs, were understood poorly or not at all. While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required before accepting the existence of the phenomenon under the motto "Extraordinary claims require extraordinary proof". In Hahnemann's day, many chemists believed that matter was Infinite divisibility#Physics, so that it was meaningful to talk about dilution to any degree. Although the hypothesis of atom#history can be traced back to the ancient Greeks, their actual size was not calculated until 1865 (by Johann Josef Loschmidt). It is now known that there are 6.02×1023 particles in a mole (Avogadro's number), so that homeopathic dilutions greater than about 24X or 12C are virtually certain to contain not even a single molecule of the initial substance. This fact is recognized by advocates of homeopathy, who assert that the essential healing power of their preparations is not found in the chemical action of molecules, but perhaps in the arrangement of the water molecules, giving rise to the expression "the memory of water". This concept is closely related to the belief in a vitalism, which was common in Hahnemann's day, but was slowly given up by the scientific community as more and more life processes came to be describable in purely materialistic terms, and as the medical model of disease came to be more and more focused on the failure of particular organs and processes in the body. This process began with the synthesis of urea by Friedrich Wöhler in 1828. The consensus among modern scientists is all of chemistry and biology can ultimately be explained ''in principle'' by the basic interactions of molecules, even if many processes are far too complex to be understood at this time. In short, the skeptic sees no evidence of a plausible mechanism by which homeopathic dilutions can possibly act. Closely related to the question of the mechanism is, in the eyes of critics, logical inconsistencies in the theory. The theory assumes that water is imprinted by the properties of molecules that it once came in contact with, even when the molecules are diluted away. If this were so, then where did the pure water used in this process come from? The water that homeopaths themselves use was once in contact with other chemicals, including chemical wastes, radioactive metals, dinosaur urine, and various poisons. According to this skeptical interpretation of homeopathic theory, all water in the world should remember its contact with millions of chemical substances and not just the properties of the chemicals that the homeopath claims will be useful. The answer of the homeopaths, that dynamization involves succussion as well as dilution, is not satisfying, first because it seems improbable that one can amplify order in a solution by shaking it, secondly because a lot of shaking goes on in the natural world as well. Why does a waterfall not dynamize the substances dissolved in the stream? It is not possible to prove that no consistent theory of potentization exists, but none is obvious and advocates have not been able to produce one. Homeopaths occasionally invoke the unusual properties of water to explain the memory effect. In addition to the problems above, a theory of homeopathy would also have to explain why dynamization works not only with water but also with alcohol and lactose, which have very different properties. Even if a homeopathic preparation somehow preserves information from the original substances, there is absolutely no plausible mechanism by which that should effect a cure. === Lack of evidence for therapeutic efficacy === Most of the published studies into homeopathy are of poor scientific quality, and that the higher quality studies tend to report less positive results., A 2003 evaluation of the whole of homeopathic research over the previous 10 years reported: :RESULTS: Clinical studies and in vitro research indicate the inefficacy of homeopathy. Some few studies with positive results are questionable because of problems with the quality and lack of appropriate experimental controls in these studies. The most recent meta-analyses on the topic yielded negative results. One of the few previous meta-analyses with positive results had serious publication bias problems, and its results were later substantially reconsidered by the main authors. The sparse in vitro homeopathic research with positive results has not been replicated by independent researchers, had serious methodological flaws, or when replicated, did not confirm the initial positive results. A plausible mechanism for homeopathic action is still nonexistent, and its formulation, by now, seems highly unlikely. :CONCLUSIONS: As a result of the recent scientific research on homeopathy, it can be concluded that ample evidence exists to show that the homeopathic therapy is not scientifically justifiable. Skeptics point out that there are very few studies that meet the highest standards of scientific research, and there is a tendency for the better studies to show less effect. Many high quality studies have been published that showed no effect. The few high quality studies that show a positive effect could be the result of statistical fluctuations, that is, if many studies are made, some will by chance appear to support homeopathy. The situation is aggravated by publishing bias—A positive result will probably be published but a negative result is more likely to be suppressed by the initiators of the study, or not written up by the researchers, or rejected by the referees or editors of the journals. The skeptics tend to reject the evidence of any study that is not double-blind, randomized, and placebo-controlled, since it has been shown many times that the results can otherwise be biased by the placebo effect, or through post hoc reasoning applied to the regressive fallacy. Skeptic James Randi has offered an award of one million dollars (U.S.) to anyone who can prove the existence of anything supernatural or paranormal. The million dollars is also available to anyone who can, by any means of their choosing, tell the difference between plain water and any homeopathic remedy of their choosing. A recent attempt to win the prize was aired on the BBC science program ''Horizon (television)''. This test, like all others to date, failed. Having concluded that the controlled studies of homeopathy are too weak to be convincing, the skeptics must still address the widespread reports of successful treatments. They begin by pointing out that anecdotal evidence of controversial phenomena is nearly useless as scientific evidence. Without control cases, it is impossible to distinguish between efficacy of a treatment and spontaneous remission. Without double blinding it is impossible to rule out observer bias and the placebo effect. Without reproduction in a separate study, it is difficult to rule out chance, fraud, or poorly understood systematic effects. === Homeopathy may not be completely harmless === The skeptical view is that homeopathic dilutions have no direct effect at all, so the skeptic naturally will not claim that the remedies themselves have any harmful side effects. The main potential harm from homeopathic treatment, therefore, arises not from the remedies per se but from the withholding of arguably more efficacious treatment or from misdiagnosis of dangeous conditions (a general criticism that can be applied in any situation of negligent practice due either to medical negligence or the proferring of medical opinion by the non-medically qualified). Moreover, even proponents of homeopathy caution that improper homeopathic treatment of conditions such as asthma, eczema, and penumonia can cause harm. == The applicability of traditional scientific procedures == While skeptics tend to reject borderline results from scientific studies because they are, due to the lack of a plausible mechanism, predisposed to believing that there can be no effect, proponents of homeopathy tend to accept these results due to the opposite predisposition based on their personal experience. In addition, they criticize an unwillingness of the establishment to invest the resources needed to test their hypothesis more thoroughly and what they see as weaknesses in the traditional methodologies. It is often said that homeopathy cannot be tested in objective studies because it is a principle that each patient and each illness be treated individually and an emotional doctor-patient bond is necessary for successful treatment. Aside from the fact that homeopathy is often not practiced this way, with many patients taking over-the-counter preparations according to the recommendations on the label, this objection has no sound basis. While it may be difficult to objectively study some aspects of homeopathic treatment, e.g., the role played by the relationship between practitioner and patient, the efficacy of homeopathic preparations in high dilution is easily studied. One could, for example, let a practitioner prescribe whatever he wants for whatever patients come to him, and then give half the patients authentic homeopathic preparations and the other half plain water, alcohol or sugar. If the two groups cannot be distinguished at a statistically significant level on the basis of the judgement of the practitioner, the reports of the patients, or objective medical tests, then the hypothesis of efficacy can be rejected. Rather than insist that all studies be double-blind and randomized, some proponents of homeopathy downplay the importance of the placebo effect by pointing to reports of successful treatment of infants and animals. Scientists answer that even in these cases double-blinding is necessary because (1) the rate of spontaneous remission must be determined, (2) the person evaluating the healing can be influenced by knowing which subjects received the active treatment, and (3) the subjects can respond to the expectations of the person administering the treatment. == Misconceptions about homeopathy == === Composition of homeopathic remedies === Many producers of homeopathic remedies also produce other types of alternative remedies, under the same brand name, which can create some confusion for the general public. A common misconception is that homeopathic remedies use only natural, and thus presumed by some to be safe, herbal components (akin to herbology. While herbs are used in homeopathy, there is also use of non-biological substances (such as salts) and components of animal origin, such as duck liver in the popular remedy oscillococcinum. Homeopathy also uses substances of human origin, which are called ''nosodes''. Another difference is that though both do use herbs, in herbology measurable amounts of the herb(s) are in the remedy, while in homeopathy the active ingredient is diluted to the point where it is no longer measurable. Some people have the opposite misconception, that homeopathic remedies are only based on toxic substances like snake venom or mercury. Since the term homeopathy is well known and has good marketing value, the public can be further confused by people who have adopted the term for other forms of therapy. For example, some companies have combined homeopathic remedies with less benign substances. Classical homeopaths claim only remedies prepared and prescribed in accordance with the principles established by Hahnemann can be called homeopathic. === Homeopathy and vaccination === The practice of mainstream medicine that most closely resembles homeopathy is vaccination. The vaccine must be closely related to the disease against which it is to protect and must be given in a very small dose to be effective. These characteristics are reminiscent of the law of similars and the law of infinitesimals. In fact, Hahnemann himself interpreted the introduction of vaccination by Edward Jenner in 1798 as a confirmation of the law of similars. Modern homeopaths view vaccination and homeopathy as fundamentally different. Although Hahnemann originally introduced low dosages in order to reduce side effects, he later believed, as do most homeopaths today, that remedies are most effective if they have been dynamized to such a degree that they have no direct chemical effect. From this point of view, the need to keep the dosage of vaccine low is simply the standard requirement to avoid consuming an excessive amount of any conventional drug. The dosage of a vaccine is still much higher than typical homeopathic dosage, and the vaccine has been diluted but not dynamized. Homeopathic critics of vaccination also consider the resemblance to the law of similars to be superficial. In most cases a vaccine is not intended to ''cure'' a disease at all, but rather to ''prevent'' it by preparing the immune system of a healthy organism to meet an attack by a pathogen in the future. Furthermore, the vaccine is usually a bacterium or virus whose capability to produce symptoms has deliberately been weakened while still providing enough information to the immune system. The "similarity" of the vaccine and the disease in terms of symptoms is thus reduced. The difference between homeopathy and vaccination is best illustrated by a comparison with nosodes, which are made from ''active'' (not deactivated) pathogens, are applied ''after'' the onset of a disease to ''cure'' it (not before to prevent it), and are administered at ''zero'' (not merely low) dosage in a chemical sense. == References == #[http://www.homeopathic.com/articles/intro/immune_system.php Homeopathic Medicine and the Immune System] by Dana Ullman #[http://www.accampbell.uklinux.net/homeopathy/homeopathy-html/chapter08.html ''Kentian Homeopathy''], Chapter 8 of ''Homeopathy in Perspective'' by A. Campbell #[http://www.thespiritofhomoeopathy.com/evolution.html The Evolution of Homoeopathy] #[http://www.dw-world.de/dw/article/0,1564,1575855,00.html Homeopathy Seeks More Acknowledgement] from Deutsche Welle #[http://www.delhihomeo.com/paperberlin.html Cost Effectiveness and Efficacy of Homeopathy in Primary Health Care Units of Government of Delhi- A study] by Dr. Raj Kumar Manchanda and Dr. Mukul Kulashreshtha #[http://www.dhu.de/wc_800/archiv/GMG.shtml Gesundheitssystem: Was bringt das neue Gesetz?] (in German) #[http://www.findarticles.com/p/articles/mi_m2843/is_6_25/ai_79794372 Magical Thinking in Complementary and Alternative Medicine] from the Skeptical Enquirer # Klaus Linde and Dieter Melchart "Randomized Controlled Trials of Individualized Homeopathy: A State-of-the-Art Review", ''Journal of Alternative and Complementary Medicine'' 4 (1998): 371-88 ([http://nhscrd.york.ac.uk/online/dare/990167.htm structured abstract]) # M. Cucherat ''et al''. "Evidence of Clinical Efficacy of Homeopathy: A Meta-Analysis of Clinical Trials", ''European Journal of Clinical Pharmacology'' 56 (2000): 27-33 ([http://nhscrd.york.ac.uk/online/dare/20001151.htm structured abstract]) # [http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812003000600007&tlng=es&lng=en&nrm=iso A critical review of the possible benefits associated with homeopathic medicine], Renan Moritz V. Rodrigues Almeida, ''Rev. Hosp. Clin.'' vol.58 no.6 São Paulo 2003 #[http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml Homeopathy: The Test - programme summary] from BBC == External links == === References === * Online etext of Hahnemann's ''Organon der Heilkunst'': [http://www.homeoint.org/books4/organon/ German original] and [http://www.homeopathyhome.com/reference/organon/organon.html English translation] === Even-handed === *A recent article on homeopathy testing from the [http://www.annals.org/cgi/content/full/138/5/393/ Annals of Internal Medicine] * [http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml BBC's ''Horizon'' on homeopathy] (transcripts, discussion, etc.) * [http://www.acampbell.org.uk/homeopathy/index.html Homeopathy In Perspective] — critical online book, covering the history and present state of homeopathy * [http://www.fda.gov/fdac/features/096_home.html FDA's view of homeopathy] === Supportive === * [http://www.arnica.com/homeo/homeo.html Introduction and Information on Homeopathy] * [http://www.homeopathy.org/ North American Society of Homeopaths] * [http://www.holisticmed.com/www/homeopathy.html Extensive Homeopathy Links from The Holistic Medicine Resource Center] * [http://www.hpathy.com/ Information and Discussion Forum] * [http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_homeopathy.shtml Complementary Medicine - Therapies: Homeopathy] BBC's "Complementary Medicine" article on Homeopathy *[http://www.homeopathy-cures.com/html/referrals_to_homeopaths.html Referrals to Certified Classical Homeopaths] * [http://www.a-r-h.org Alliance of Registered Homeopaths] * [http://www.homeoint.org/english/index.htm Homéopathe International] — The English language version of ''Homéopathe International'' * [http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html Homeopathy Timeline] with a wealth of historical and biographical information === Critical === * [http://www.randi.org/jr/02-02-2001.html A skeptic's view of homeopathy] * [http://www.csicop.org/si/2001-11/alternative.html Magical Thinking in Complementary and Alternative Medicine] * [http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html Quackwatch on homeopathy] * [http://www.homeowatch.org/ HomeoWatch] — A Skeptical Guide to Homeopathic History, Theories, and Current Practices, operated by Stephen Barrett, M.D. (founder of Quackwatch) * [http://www.bbc.co.uk/dna/h2g2/alabaster/A954740 H2G2 entry on homeopathy]. * [http://www.skepdic.com/homeo.html The Skeptics Dictionary] * [http://www.acsh.org/search/txtQuickSearch.homeopathy/health_result.asp "The Scientific Evidence on Homeopathy"] - American Council on Science and Health *[http://www.skepticreport.com/health/hahnemann.htm A close look at homeopathy] *[http://www.skepticreport.com/health/dilutiondelusion.htm Dilution or Delusion?] *[http://www.ncahf.org/pp/homeop.html National Council Against Health Fraud Position Paper on Homeopathy] Homeopathy Alternative medical systems Professional CAM treatments Alternative medical treatments derived from western culture Pseudoscience
==Previous discussion archive== Previous discussions are archived here. *Talk:Homeopathy/Archive 1 *Talk:Homeopathy/Archive 2 *Talk:Homeopathy/Archive 3 *Talk:Homeopathy/Archive 4 =="Controversial" - A simple compromise - I hope...== I'm changing the intro paragraph so that it notes that homeopathy is controversial, and it notes that it's "alternative medidicine." But it will not include the phrase "controversial system of alternative medicine," so as to avoid the adjective "controversial" been misread as a modifier of "system of alternative medicine," which would imply that it's more controveral that other forms of alt. medicine. Hopefully this will work for everyone. Intro paragraph: :Homeopathy (also spelled homœopathy or homoeopathy), from the Greek language words ''homoios'' (similar) and ''pathos'' (suffering), is a system of alternative medicine, notable for its use of remedies without chemically active ingredients. The theory of homeopathy was developed by the Saxony physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but is controversial because its principles are contrary to accepted scientific methods and to the principles of conventional medicine. User:Blackcats 04:31, 2 Jun 2005 (UTC) :It's inadequate to say that homeopathy is controversial simply because, under well-established principles, it can't possibly work. The experimental results are also important, and were alluded to in the earlier version. At any rate, your attempted compromise has now been replaced by a rapidly pro-homeopathic version. As long as the devotees of homeopathy keep trying to turn this article into a commercial for their particular brand of quackery, the edit warring will continue. (Mind you, I'm not trying to get the article to ''state'' that homeopathy is quackery. We don't answer one violation of the NPOV policy by substituting another.) User:JamesMLane 05:39, 3 Jun 2005 (UTC) James - the attempted compromise which I edited the article with was a very slightly modified version of what you yourself proposed: :Also, for clarity, I think this lead section should be broken into two paragraphs, and I've made some wording changes from your version (I didn't like "scientific notions", for example). So what about this version: ::Homeopathy (also spelled homœopathy or homoeopathy), from the Greek language words ''homoios'' (similar) and ''pathos'' (suffering), is a controversial system of alternative medicine, best known for its use of certain remedies that are so highly diluted as to have no chemically active ingredients. The theory of homeopathy was developed by the Saxony physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but its principles are contrary to accepted scientific beliefs as well as to the principles of conventional medicine. ::Homeopathy essentially treats "like with like". The patient describes his or her symptoms in detail. The practitioner considers the physical and psychological symptoms to determine the image of the disease in the patient. The practitioner then prescribes extremely small, nontoxic doses of a substance thought to match the disease image or complex in the patient. :User:JamesMLane 23:18, 17 May 2005 (UTC) I simply replaced "scientific beliefs" with "scientific methods" and moved the "controversial" so that it wasn't directly modifying the phrase "alternative medicine." For the record, I'm no fan of homeopathy, and I do feel that it's more dubious than other forms of alt. medicine, but I didn't feel that Wikipedia should assert that as such. Instead it should present the objective facts and let people come to their own conclusions. Furthermore, the fact that some annonomous IP users (who for all we know could be straw-man internet sock puppets) have been ''vandalizing'' the page should have no bearing on any negotiations or attempts at compromise between good faith editors like you and I. --User:Blackcats 20:22, 3 Jun 2005 (UTC) :The last sentence of the above rewrite is not exactly accurate nor does it make much sense. I'd suggest the following: "The practitioner then prescribes a substance which is considered to produce a similar disease image in healthy persons ("provings"), usually in very dilute doses. --User:Rudiverspoor 03:25, 4 Jun 2005 (UTC) ::Blackcats, I agree that the pro-homeopathic editors can't be considered as a monolithic bloc. My point was only that, although I was hopeful that we were making progress toward a consensus version, we have no hope of reaching stability if people come in and make edits like the one the anon made. Also, I don't necessarily agree with everything that was in a prior edit, even one of my prior edits! I think I used the term "beliefs", but then Jooler pointed out, correctly, that this conveyed an inaccurate picture of scientific conclusions (because science isn't a belief system, unlike homeopathy and religion). :::And that's why I changed "beliefs" to "methods." I'm sure most every scientist would be happy with that wording. That's one of the first things we went over in most of the science classes I've taken - the scientific method. User:Blackcats 19:46, 5 Jun 2005 (UTC) ::My problem is with flatly asserting that homeopathy is a form of alternative medicine. For treating cancer, chemotherapy, radiation, and surgery are forms of medicine. Crystal healing and the like is not a form of medicine. That's why I wanted to qualify that assertion by including the word "controversial". If that's a problem, I'd be OK with the more direct statement if it's attributed as an opinion, rather than being asserted: "Homeopathy is said by its practitioners to be a form of alternative medicine...." Would that raise fewer hackles than the word "controversial"? User:JamesMLane 05:06, 4 Jun 2005 (UTC) :::James, you seem to be saying that homeopathy is not a form of alternative medicine. If you read the alt medicine article I think you'll see that homeopathy falls well within the accepted definition. --User:LeeHunter 13:44, 4 Jun 2005 (UTC) ::::I agree with User:LeeHunter. If you want to argue that alternative medicine is inherently a misnomer, then you should fight it out over there. Once you change the name of that article to controversial medicine or alternatives to medicine or whatever, then we will be happy to change the wording here. Until then, we have other bones to pick. User:Art Carlson 16:42, 2005 Jun 4 (UTC) :::::I do think that the phrase "alternative medicine" is a masterpiece of deceptive marketing, but I agree that that's beyond the scope of this article. My only point was to explain why I favored the wording "a controversial system of alternative medicine". Rudi suggested above that saying it's alternative medicine establishes that it's controversial. I disagree, because not everyone knows enough about the field to know that anything called "alternative" is controversial. We should certainly use the phrase "alternative medicine" and wikilink it, but we should include "controversial" so the reader is notified of that key point without having to read the other article. User:JamesMLane 23:02, 4 Jun 2005 (UTC) ::::::And that was the whole point of my compromise! We would be explicitly stating that it was controversial in the first paragraph, but we wouldn't use wording (at least not in that first paragraph) that could be read to mean that it was more (or less) controversial that other forms of alt. medicine. User:Blackcats 19:40, 5 Jun 2005 (UTC) Why say it's a "system of *alternative* medicine"? Wouldn't it be more accurate to state that it's simply a "system of medicine". This would then cover all the families and communities for whom Homoeopathy is the only system of medicine and not an alternative. And why *controversial*? There are two sides to every controversy, which means that all allopathy-related articles would also have to be re-edited and described as *controversial* too. Or is Wikipedia intended as a partisan resource? == Scientific Criteria == Could someone explain to me what are the minimum criteria referred to in the intro paragraph? This seems to me to be different and more radical from stating that it goes counter to current principles of science. --User:Rudiverspoor 03:32, 4 Jun 2005 (UTC) I would also like some clarification of how homeopathy goes counter to the scientific method, rather than to current principles held, based on the following dictionary definition: :The principles and empirical processes of discovery and demonstration considered characteristic of or necessary for scientific investigation, generally involving the observation of phenomena, the formulation of a hypothesis concerning the phenomena, experimentation to demonstrate the truth or falseness of the hypothesis, and a conclusion that validates or modifies the hypothesis. --User:Rudiverspoor 03:37, 4 Jun 2005 (UTC) ::One variation of the language that we've used (the one in the article as I write this) is that "neither its empirical nor its theoretical foundation meets the minimum criteria of the scientific establishment." ::*The theoretical objection is that there is no known mechanism for "water memory" or anything else that could produce an effect in the absence or virtual absence of active ingredients. The phrase "no known mechanism" can be misleading. Homeopaths seem to be found of saying that science doesn't know everything. That's true, but scientists have some idea of what they know and what they don't know. Perpetual-motion machines would violate conservation laws that have held up in a wide variety of circumstances. It's conceivable that there's someplace in the universe where conservation laws are violated because hydrogen atoms are popping into existence, but it's very unlikely that conservation laws are violated by some collection of capacitors, conveyor belts, and old mufflers that Uncle Elmo assembles in his garage. Similarly, the point about "no known mechanism" is that these sorts of chemical reactions have been studied intensively for many years under many different conditions. It's kind of like saying there are no known unicorns. We not only haven't seen them, but we have good reason to think that, if they did exist, we would have seen them by now. ::*The empirical objection is that, in more than two centuries, homeopaths have failed to come forward with any hypotheses that have been tested and found to hold true. Reproducible results are very important to the scientific method. Given that there have been many tests, it would be expected that some of them, by chance, would suggest a healing value beyond the placebo effect. The overall results of the testing, however, have been more consistent with the hypothesis of rejecting homeopathic claims. ::I don't think the lead section (or any other) should assert that homeopathy is bunk, but I think those two points of the criticism are each worth at least a mention in the lead. (This formulation of the skeptical view seems more accurate to me than one that invokes "the scientific method".) The elaboration of these criticisms, along with the elaboration of homeopathic claims and homeopaths' responses to the criticisms, is of course left to the body of the article. User:JamesMLane 04:49, 4 Jun 2005 (UTC) ==Definition of Remedy== According to answers.com *Remedy - ''Something, such as medicine or therapy, that relieves pain, cures disease, or corrects a disorder.'' **Since I don't believe that homeopathically treated water does relieve pain, cure disease or correct disorders, I object to the use of this word in the opening paragraph. User:Jooler 18:14, 4 Jun 2005 (UTC) :A placebo is also a remedy and often work as well as many conventional medicines. You can argue whether or not homeopathy works better than a placebo but you cannot dispute that it works as well as a placebo. In other words that in some cases pain is relieved, diseases cured and disorders corrected. --User:LeeHunter 18:50, 4 Jun 2005 (UTC) :that isn't the defintion of a homeopathic remedy though.User:Geni 19:46, 4 Jun 2005 (UTC) :Conventional medicines are not approved unless they work ''better'' than a placebo. User:Art Carlson 20:46, 2005 Jun 4 (UTC) ::That's true (at least in theory) but it doesn't really have anything to do with the point being disputed. Conventional doctors also prescribe placebos. I note that the remedy article indicates that nowadays the word is more typically applied to herbal medicine than pharmaceuticals. --User:LeeHunter 22:39, 4 Jun 2005 (UTC) :A placebo is not a remedy. Placebos do not in and of themselves "relieve pain, cure disease, or correct a disorder" - that is the action of the mind. Certainly the use of the word remedy might now more readily apply to herbal concoctions rather than pharmaceuticals. But I still dispute that the word ''remedy'' can readily applied to something which I believe that does not actually have any remedial properties whatsover. User:Jooler 11:13, 5 Jun 2005 (UTC) ::You can relieve pain or cure a condition by something you do (taking a vacation) or something you think (mother doesn't hate me after all). The fact that the healing action takes place in the mind is an interesting side note, but doesn't alter the fact that the healing was triggered by taking the little white pill, having psychotherapy or going on holiday. Aside from all this pedantic and semantic stuff, "remedy" is the specific term that homeopaths use. Unless there's a compelling reason, I think we should keep using it. And one final note, homeopaths have millions of satisfied clients like myself, people who will tell you that conventional medicine and other forms of alternative medicine did nothing (or made things worse or caused other problems) whereas homeopathy simply provided a safe, inexpensive and permanent cure. Perhaps, since 'science' says homeopathy can't possibly work, we're all just delusional, but when it comes to deciding whether something is or isn't a "remedy" I think the opinions of the actual patients should count for something. --User:LeeHunter 13:24, 5 Jun 2005 (UTC) :::That hits the nail on the head. There are millions of people that think homeopathy works because they were sick, they took a homeopathic preparation, and then they were better. A scientist is trained to ask critical questions about this hypothesis. Are there also people who were sick, took a homeopathic preparation, and didn't get better? Are there also people who were sick, didn't take a homeopathic preparation, and got better anyway? How many people were in each of these groups? With what accuracy can I determine these numbers? If more people really do get better after taking a homeopathic preparation, is it the result of something in the pill or something else that happened? Could there be reasons that people say they got better when they really did not? Could an observer sometimes conclude people get better when they really do not? How can I design a study to rule out as many of these possible confusing factors as possible? I don't mean to denigrate the opinions of satisfied customers of homeopathy, but if you are interested in what is ''really'' going on, their opinions "count" less than the few good studies which have been made. User:Art Carlson 14:08, 2005 Jun 5 (UTC) ::::But you're mixing up several issues here. The question of whether homeopathy performs better or worse than a placebo in clinical trials is one question. Whether "remedy" is the appropriate word for a substance used in homeopathy is another. I recognize that one of the reasons that 'remedy' has fallen out of favor in conventional medicine (in favor of more neutral terms like drugs, pharmaceuticals etc) is that, to a scientist, the word does imply a positive outcome and therefore doesn't lend itself to the world of double-blind studies etc. But whether it actually works better or the same as a placebo has nothing to do with the how the word "remedy" is commonly used in the English language and especially within homeopathy. Even within homeopathy, it's difficult to find the "right" remedy. Sometimes a homeopath will try many remedies and not find one that produces an effect. Even when it obviously doesn't work, the stuff in the bottle is still known, to patient and doctor, as a "remedy". --User:LeeHunter 15:11, 5 Jun 2005 (UTC) :::::You're right, I got sidetracked. I apologize. As to the issue at hand, I personally have no problem with using the word "remedy" in the sense of "intended to remediate". On the other hand, there must be synonyms, maybe "preparation", that would satisfy everybody. User:Art Carlson 20:09, 2005 Jun 5 (UTC) :With regard to the use of the word ''remedy'' I think my re-wording now satisfies my concern, it no longer states that homeopathic products are remedies, merely that homeopaths consider them remedies. With regard to the other issue, Art makes the point eloquently, do homeopaths really want to know what is going on when someone reports the success of a homeopathic treatment, or are they just in the business of quakery and exploiting people. Sine scientia ars nihil est. User:Jooler 16:27, 5 Jun 2005 (UTC) ::A good homeopath works like a good doctor. Both are focused on helping the patient improve. They operate from different models, have different standards of wellness and use different bodies of knowledge but the focus is on whether the patient is better or worse. Bad doctors, and I've seen a few of those, ignore the patient and rely on the 'science' even in the face of contrary reports from the patient. You like to characterize homeopaths as near criminals exploiting the gullible. There are definitely many poor homeopaths out there (and given the lack of standards there are unquestionably more bad homeopaths than there are bad doctors) but there are also many who are sincere, modest and extremely knowledgable (quite a few are also MDs). The best homeopaths (I'd count my own homeopath in that group) have skills of observation and analysis which are superior to any doctor I've met. So, in answer to your question, homeopaths do want to know what is really going on when a patient reports improvement. Like any good doctor, they don't much care whether or not the improvement fits the current state of science, only whether it is real and whether it is lasting. One key difference though, is that homeopaths are completely focused on deep and lasting cures. For example, if someone has a recurring rash a regular doctor will generally prescribe an ointment or antibiotics to control the symptoms. A homeopath, on the other hand, would find that approach appalling and wouldn't be satisfied until they found a "remedy", something that solved the problem permanently. --User:LeeHunter 17:30, 5 Jun 2005 (UTC) :::evidence?User:Geni 20:46, 5 Jun 2005 (UTC) ::::Of what? --User:LeeHunter 21:57, 5 Jun 2005 (UTC) :::::of suppression, that homeopaths can cure anything beyond the placebo effect, that genus epidemicus is not part of homeopathy and that individulisation is real. For your stament to be correct you need to be able to provide evidence for all of the above. :::Your choice of a rash as an example is an interesting one. A rash is very often a symptom of something more profound, like an allergy or a deficiency or an emotional problem or a more chronic illness. As a senior software designer working with more junior colleagues I often find that that they try to patch up a bug by working around it, for example if a function consistently returns a value one less than it should (the off by one error is not uncommon in software) they might simply add 1 to the result. This is a simplification, but it illustrates the point. My response to this kind of patching up is to state -- "you are treating the symptoms and not the disease". If a doctor prescribes ointments etc.. without looking more deeply at the reasons for the condition, then they are also guilty of treating the symptoms and not the disease. For a homeopath, a patient has a cough, what does he do? - he prescribes a solution made (before dilution) from a substance that would induce coughing. The supposed "holistic" approach of homeopaths is a myth. Even if they were prescribing products that were known to cure they are only aiming to treat the symptoms, just like a bad doctor. I find your bald statement "there are unquestionably more bad homeopaths than there are bad doctors" very illuminating. User:Jooler 22:10, 5 Jun 2005 (UTC) ::::I'm afraid you only have the most superficial idea of how homeopathy works. In your view: "This stuff makes people cough so if we dilute it, it will fix a cough." That is not what happens at all. It's almost unavoidable that people get that impression if their only exposure to homeopathy is through articles like this, but it's completely wrong. There are probably hundreds of remedies that include "cough" as just one of hundreds of data points. And then the cough is only piece of a huge picture that covers the patient. The homeopath (a good one anyway) will spend a long time getting to know the patient on a deep level (often going back to childhood), organize the patient's story into themes and patterns, sift through a staggering quantity of information and sort through thousands of remedies to try and find the one that exactly fits the patient like a cryptographic key. If he or she hits the right one, not only the cough will improve, but anything else that is wrong with the patient should also disappear (sometimes it takes a combination of remedies over time). Contrast that with the way your family doctor works. "Gee that's a nasty cough! Here try this new cough suppressant the Bristol-Myers guy dropped off this morning along with tickets to that big conference in Thailand!" --User:LeeHunter 22:43, 5 Jun 2005 (UTC) :::::Nice strawman about conventional medicine. Now a homeopath may do all that but we know that hahnemann was prescibeing sulphur an incredibly large amount of the time[http://www.otherhealth.com/showthread.php?t=5122]. If you ever look through a list of what most homeopaths prescribe it's the same remedies again and again arnica, nux vom, the so called polycrests. There may be thousands of homeopathic remedies but I doubt more than 30 or so are used with any real regularity (I doubt it is even that high but no matter).11:03, 6 Jun 2005 (UTC) ::::::Speaking of strawmen, why do you always go back 250 years to try and disprove what homeopathy is doing today? There are still a few homeopaths who think that Hahnemann is the last word but, like everything else in the world, most have moved on. One could also say that conventional medicine is rubbish because at the time of Hahnemann surgeons didn't wash their hands. Its nonsensical. Regarding your doubts about how many remedies are commonly used, I can assure you that a good homeopath does work from a repertoire of thousands of remedies and will frequently prescribe the so called small remedies. I myself was given one of the more esoteric, recently proved remedies and the effect was striking. Perhaps it was still a 'placebo' but it makes me wonder why doctors and other forms of alternative medicine weren't able to provide such an amazing "placebos". Of course, the more well-known remedies are no doubt prescribed more frequently, but that's hardly informative. Your average doctor prescribes antibiotics for conditions that he knows aren't treatable by antibiotics. It doesn't mean antibiotics don't have their place or that lesser known pharmaceuticals are not used. --User:LeeHunter 11:31, 6 Jun 2005 (UTC) :::::::it is no longer considered ethical for doctors to prescribe placebos. Trying to get hold of treament records for modern homeopaths is difficult without resorting to theft.User:Geni 17:44, 6 Jun 2005 (UTC) A 'remedy' in Homoeopathy is a potentized medicine - prepared as Hahnemann describes - that has been prescribed correctly and is therefore acting curatively. Unless and until it is applied in this way it remains a potentized medicine. :No that woruld be the clasical defintion which is far from universal.User:Geni 10:34, 10 Jun 2005 (UTC) == NPOV tag == What points are open that require the NPOV tag (which, if I follow correctly was introduced by Geni), as opposed to the normal editorial differences? User:Art Carlson 20:58, 2005 Jun 4 (UTC) :none that I know of. You may want to ask Leifern or Rudi.User:Geni 21:29, 4 Jun 2005 (UTC) ::Sorry, I've been off for a while, but you guys seem to have been having a good discussion. For now, the lead part seems a very workable draft as we develop the body of the article. --User:Rudiverspoor 01:54, 8 Jun 2005 (UTC) == Some specific controlled studies and clinical trials == Hello, Geni,
Don't you think you might have compressed some useful information away in the introductory sentences to this section?([http://en.wikipedia.org/w/index.php?title=Homeopathy&diff=15225682&oldid=15225599 diff]) I don't really know what your objection is, either, since your reference [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14] seems to be to a pay site. At least I just get the cryptic title ("Malathion A and B esterases of mouse liver-I") of a paper from 1975. I agree that my paragraph is probably out of place here, but I think it should be incorporated into the section ''4.2 Lack of evidence for therapeutic efficacy'', rather than deleted.
More generally, I would like to find and briefly analyze the best 2 or 3 studies in each of these categories and/or the best 2 or 3 ''positive'' studies. What I am after is a well-informed and transparent basis for judging the quality of the evidence. This task is not too easy because the proponents of homeopathy don't seem to agree on what their best evidence is. I hope you can help with this.
User:Art Carlson 13:01, 2005 Jun 15 (UTC) :Try here for a reference[http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812003000600007&tlng=es&lng=en&nrm=iso]. The problem is that the over the last few years there has bene a lot of negative reaseach into homeopathy. Before then the balance probably in favor of homeopathy although the quality of studies ranged between poor and appalling. The link was not to the most complete list of studies of homeopathy around (in fact it was to an extreamly short list of studies. The true total is around 100). In terms of anaylising studies there are only three studies that I know of that follow sciencific protocols and full homeopathic ones (although there are a few more that follow the methods of homeopathy that are often used in practice). Two of them are already in the article the third is [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11316508&query_hl=13] User:Geni 13:44, 15 Jun 2005 (UTC) ::Thanks a lot, Geni. Your first reference is very enlightening. It leaves me with the question of what to do with this section. I created it originally as a catch-all for details that were cluttering the main article when I was reorganizing it. I thought it would be useful either, like I said, to give an informed basis for evaluating the quality of the evidence, or to answer proponents who say, Well what about the study by so-and-so proving such-and-such? After reading the review cited, I have grown faint of heart at the idea of in any way doing justice to the quality and quantity of recent research. And we haven't heard much from proponents pushing any particular research results. (I am left with the impression that they are not that interested in science. I guess otherwise they would not be proponents.) So the radical question is: Do we need this section at all? We can put a few uncompromising summary statements into the "skeptical" sections and link to the review for those interested in the details. What do you think? What do our resident homeopaths think? User:Art Carlson 08:53, 2005 Jun 16 (UTC) :::homeopaths do have some interest in science but most of them are not to0 worried about it. Danna ullman was probably the last to really try and make the case that homeopathy had been proved scientificaly and his book is getting dated. Other than that there is the reseach funded by boiron into ultra molecular trials. Since we have no idea about publication bias in this area (although there are reasons to suspect it is quite high) it is a bit difficult to come to solid conclusions in this about this work.User:Geni 12:22, 16 Jun 2005 (UTC) ::::Is the scientific case strong enough to move the section on "Lack of evidence for therapeutic efficacy" from "The skeptical view of homeopathy" into its own section? Or to rename "The skeptical view of homeopathy" to "The scientific status of homeopathy"? (And moving "Homeopathy not completely harmless" someplace else.) User:Art Carlson 11:47, 2005 Jun 17 (UTC) ::::::we don't write articles from a scientific POV.User:Geni 12:00, 17 Jun 2005 (UTC) :::::::The information on the studies is "scientific" and leads one to be "skeptical" of homeopathy. The question is, which label is more accurate, more informative, or more neutral? I certainly won't press the point. That would be spoiling for a fight. I do plan to throw out the section on "Some specific ..." and move the introductory citation of Renan and Rodrigues to "The skeptical view of homeopathy" if I don't hear any objections soon. User:Art Carlson 12:10, 2005 Jun 17 (UTC) == A possible mechanism == I added this section as a rebuttal to the oft-repeated skeptical position that "there is no possible mechanism for homeopathy". While this is true re. potentization/water memory etc, it is not at all the case re. the Law of Similars. The burgeoning field of "Darwinian medicine" is based on a realization that symptons can sometimes be a "good thing", rather than something to be treated. Isofar as the Law of Similars advocates substances that induce specific symptoms, Darwinian medicine provides a clear mechanism for the Law of Similars. :Your insert states what appears to be your opinion that "there is a plausible (though unproven) potential mechanism". My opinion is to the contrary. The mechanism you describe is not plausible, because of the negligibly small quantities of any active ingredient in a typical homeopathic remedy. :I'm not going to edit your insert by adding my opinion that this theory is absurd. My opinion doesn't matter -- but neither does yours. I'm deleting the whole section. If you want to restore it, provide a citation to some notable spokesperson who says it, and attribute it to that spokesperson rather than stating it as a fact. User:JamesMLane 07:43, 20 Jun 2005 (UTC) :: Did you actually read the section before deleting it? It specifically states that the mechanism is for the Law of Similars, not Potentiatization, so your objection (negligibly small quantities) is entirely baseless. And the section clearly states that it is a *plauible* mechanism, not a proven one. Unless you can provide a good argument as to why this mechanism is unplausible (since it is prima-facia highly plausible), your objection is merely dogmatic. I'm restoring the section; if you want to delete it, say why the mechanism is implausible (and try and avoid using a straw man this time). Since you insist on a "authority", mechanism will be attributed to Dana Ulman, MPH. http://www.homeopathic.com/articles/intro/immune_system.php JColvin, 22 Jun 2005 :::You apparently don't have much experience with Wikipedia. We try to focus on ideas and we Wikipedia:No personal attacks. Given that my comment on this talk page quoted part of the passage verbatim, it was unnecessarily snide of you to ask whether I had read the passage. You can express your disagreement without such inflammatory phrasing. To give the obvious answer to your question, though: Yes, I did read it before deleting it. Let's assume hypothetically that St. Fraudswort herb causes fever. Let's further assume hypothetically that the misnamed "Law of Similars" (actually, the "Wild and Unsubstantiated but Potentially Lucrative Conjecture of Similars") is completely true, and that an appropriate dose of St. Fraudswort will therefore cure a fever. It remains true that this is ''not'' a plausible mechanism by which actual homeopathic "remedies" could work, because the dilutions are so great that most of the patients are not actually receiving any St. Fraudswort, or are receiving a negligibly small amount. You might as well say that a solution of St. Fraudswort, whether diluted or undiluted, will cure headaches, because hokumweed causes headaches and like cures like. The "Law of Similars" can't apply unless, at a minimum, the patient is receiving a substance similar to what causes the symptom. :::Furthermore, it's not my burden to prove that the mechanism is implausible. I'm not saying that the encyclopedia should assert, as a matter of fact, that the purported mechanism is impossible (although it is). Our NPOV policy precludes the flat assertion that it's plausible ''or'' implausible. That's why I "insist on a 'authority'" -- because I follow the policy. We can report an opinion on a disputed subject, provided we make clear that it ''is'' an opinion, and whose. :::For now, I'll recast the subsection in accordance with Wikipedia rules. Longer term, I'm not sure it belongs in the article, whether attributed or not, and even if it's kept it should probably be somewhere else. User:JamesMLane 19:42, 22 Jun 2005 (UTC) ::::If you (JColvin) read the section on "Lack of a mechanism", you know that it refers ''only'' to the Law of Infinitesimals, not to the Law of Similars. It is true that the latter is not as crassly at odds with science as the first. Is there a good reason for including a counter argument to an objection that nobody makes? Or can you cite someone arguing that "there is no possible mechanism for the Law of Similars"? If we want to include more detail on the Law of Similars, then it belongs somewhere else, probably in the section so titled. And then we would have to include a bit about the difficulty of knowing just what the "Law" is supposed to be saying, and about the fact that there are more exceptions than applications of it. I will delete the section again. If you like, you can reinsert it under "The law of similars" and I will edit it there. User:Art Carlson 19:54, 2005 Jun 22 (UTC) :::::Ok, reinserted in section (Law of similars). Please refer to the final sentence of the section on Lack of mechanism; "Even if a homeopathic preparation somehow preserves information from the original substances, there is absolutely no plausible mechanism by which that should effect a cure."; this implies that there is no mechanism for Law of Similars. Similarly, "While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required .. ", does not qualify the lack of mechanism to merely the Law of Infinitesimals. If this section indeed relates *only* to the Law of Infinitesimals, then I suggest this final sentence be removed (I also note that this sentence is a flat assertion lacking authority, contra the wiki rule mentioned by James above), and that the relevance of the section be explicated (perhaps by changing the title to "Lack of a mechanism for Law of Infinitesimals), and editing the other sentence quoted above. :::::Since homeopathy skeptics usually claim merely that "there is no mechanism for homeopathy" without explicitly qualifying the objection only to Law of Infinitesimals, I think it is valuable to reference a possible (IMHO plausible), albeit unproven mechanism. :::::Since the new subsection (Possible Mechanism) merely relates to a *potential* mechanism, and notes that the mechanism is hardly foolproof (ie. substance could cause damage), an exhaustive list of exceptions does not seem warranted. :::::Re. (JamesMLane objecion); again, this mechanism applies *only* to law of similars. It has no bearing on debate as to quantity of active ingredient (although I would note that many retail homeopathic remedies are not merely distilled water, but contain varying amounts of active ingredient). JColvin 2005 Jun 22 ::::::active ingredient? botulism A toxin is about the only thing that can have an effect even at the relitavly low potency 6X.User:Geni 02:26, 23 Jun 2005 (UTC) :::::::Not true. 6X corresponds to ppm. Endocrine disruptors, hormone mimics, dioxin etc are active at ppb. http://californiaagriculture.ucop.edu/0204JA/briefs.html ::::::::no since we are dealing with aquious solutions ppm is 1 mg/dm3 . Now if the mother tinctures were at 1 mole (they are unlikely to be anything near that) and the molicules wieghed 100 daltons then we are already down to 0.1 ppm. Now we know that the solubility of this molicules isn't very high (big molicules never are) and the mother tinctures tend to be of a pretty low concentration so if you think you are breaking the PPB mark I sugest you do some more reseach into how homeopathic remedies are in fact made. we will deal with grafting (wich destories your case completely) latter.User:Geni 03:10, 23 Jun 2005 (UTC) :::::::::If you want to argue that most homeopathic remedies are pure distilled water and function on placebo alone, I won't disagree. Just don't throw out the baby (rationale for law of similars) with the distilled water.User:Joncolvin 05:06, 23 Jun 2005 (UTC) ::::::::::Thee "rationale" is not consistant with our knowlage of the immune system and desease.User:Geni 12:19, 23 Jun 2005 (UTC) ==Homeopathy not completely harmless== Zicam regularly contians active ingredents and claims to be homeopathic.User:Geni 11:58, 22 Jun 2005 (UTC) ==Rethinking tone of whole article== I am joining the discussion before introducing any substantial changes. I am a homeopath with an strong interest in philosophy of science. My main concern with the article is that it falls flat on its face by trying to be exegetical and evaluative all at once. Regardless of your individual inclinations for or against homeopathy, the purpose of an encyclopedia entry is to present the subject matter from the perspective of its internal logic. One doesn't, for example, begin an article on Christanity with something like "...is the world's largest religion, notable for its controversial tripartite characterization of God. Moreover, no plausible mechanism for the existence of God has been found." The conrovertiality of homeopathy need not be alluded to until later on (entirely contained within extensive "Skeptical View..." and "Mechanism..." sections) because any semi-intelligent reader will realize along the way that there are 'interesting' features to homeopathy. I would like to request that those interested in the discussion read the following article: http://www.thespiritofhomoeopathy.com/evolution.html which not only provides a superb historical overview of homeopathy (albeit with an over-representation of info on Indian homeopathy, where the article was written), including some recent developments that are controversial even within the homeopathic community, but illustrates how to approach a subject-matter without prejudice, but just describe it for what it is. At the end of the article one isn't compelled to cry out "Wow! Homeopathy is incredible"; rather, one is able to begin evaluating the subject-matter from a position of knowledge. More specifically for our purpose, the arrangement of the article is, I believe, the proper way to arrange the early part of this entry. Only following a similarly comprehensive description should the various complexities be dealt with. Could we discuss the issue I brought up and create a fresh outline before returning to the text? It may require several passes just to arrange the sections correctly. User:Davidnortman 05:55, 23 Jun 2005 (UTC) ::The article you reference has some interesting historical material, though an awful lot of stuff I found uninteresting. More to the point, its POV is thoroughly homeopathic, not in any way a paragon of encyclopedic style. User:Art Carlson 08:44, 2005 Jun 23 (UTC) :I assume you are referring to the overview/preface? I think it is kosher to refer to controversy here; the preface should give a quick summary of the entire article, and controvery is definitely part of the parcel for this subject. The analogy with religion is not entirely fair; homeopathy claims to be a science, Christianity does not. Most people are well aware that religions are controversial; this might not be the case for those new to homeopathy. User:Joncolvin 05:42, 23 Jun 2005 (UTC) There should be a single reference to controversy toward the end of the introduction, alluding to the fact that following the description of homeopathy will be critical analysis. As of now there are two references which immediately divert the reader away from first understanding homeopathy on its own terms toward evaluating it prematurely. (I find that most people that criticize homeopathy know almsot nothing about it, and I presume that the purpose of a critical perspective here is to produce people who are critical of homeopathy once having learned about it.) A proper article consists of exegesis followed by critique, in this order and with clear separation between the two. For example, the use of submolecular dilutions should be in the exegesis, and a criticism of the same in the critical section later on, not immediately following the description so as to interrupt the still-incomplete narrative flow. The overriding concern should be for clear rhetoric (in the classical sense of the term) which permits the reader to make proper judgments. User:Davidnortman 06:06, 23 Jun 2005 (UTC)
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Homeopathy
Homeopathy (also spelled homœopathy or homoeopathy), from the Greek language words ''homoios'' (similar) and ''pathos'' (suffering), is a system of alternative medicine, notable for its controversial practice of prescribing water-based solutions that do not contain chemically active ingredients. The theory of homeopathy was developed by the Saxony physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but neither its empirical nor its theoretical foundation meets the minimum criteria of the scientific establishment. Homeopathy calls for treating "like with like" (law of similars). The practitioner considers the totality of symptoms of a given case. He or she then chooses a remedy that has been reported in a homeopathic proving to produce a similar set of symptoms in healthy subjects. This remedy is usually given in extremely low concentrations prepared according to a procedure known as potentisation, because it is held that this process gives higher dilutions more therapeutic power. == Basic principles == === Theory of disease === The conventional theory of disease in Hahnemann's time was based on the four humours. Mainstream medicine in those days focused on restoring the balance in the humours and thus the vital force by either removing an excess of a particular humour (through such things as bloodletting and purging, the use of laxatives, enemas and nauseous substances that made patients vomit) or by suppressing symptoms associated with the humour(s) causing troubles, for instance giving patients substances associated with cold and dry if the patient was hot and wet (e.g. feverish). The late 18th century was a time of intense exploration, and many new diseases were being identified. The model of internal humors was proving to be inadequate. For example, many new diseases were clearly associated with certain geographic locations, which was difficult to explain through totally internal mechanisms like humours. Instead, more scientists were considering a model of external causes. One variation was the idea of independent outside agents in the air, known as ''miasms'' or simply "bad airs". For example, malaria was thought to be caused by the bad airs found in southern swamps and jungles, explaining why it struck down people travelling in those areas. Hahnemann's idea was that by suppressing or going against the humours, doctors were sabotaging the body's own efforts to heal itself. He considered symptoms to be the way the body fought disease; for example, fever was its attempt to make itself warmer to fight whatever was ailing it. Unlike the humour-based logic, which would attempt to cool the feverish patient, Hahnemann felt that if the body wanted to be warm, making it warmer would be the proper solution. From this he developed the expression of the "like-cures-like" principle. Scientific medicine has discarded both the theory of the four humours and the theory of miasms (and similar ideas of that time), in favour of the germ theory of disease as part of a physiological model, based on the work of scientists like Louis Pasteur, Alexander Fleming, and Joseph Lister. Beginning with his early work, Hahnemann rejected the prevailing physical model, in favour of seeing disease as more dynamic (spirit-like). He considered the spirituality factors as the root cause of all disease, what he termed the "highest disease." Most later homeopaths, in particular James Tyler Kent, have tended to put even more emphasis on spiritual factors. Vitalism was more or less a part of mainstream science through the 18th century. Whereas modern medicine sees bacterium and viruses as Koch's postulates, some modern homeopaths regard them as effects, not causes, of disease. Others have to some extent adapted to the views of modern medicine by referring to disturbances in and stimulation of the immune system, rather than the vital force. In accordance with this view of disease, classical homeopathic treatment requires an interview, known as "anamnesis", which may take an hour or more, to determine the totality of the patient's symptoms. Hahnemann stated that a person could have more than one disease at a time, each of which might be contributing to the symptom picture of the patient. Hahnemann's approach was that the practitioner should first seek to treat the constant nature diseases, as these can more readily be identified in most cases (by cause, e.g. Arnica for contusion disease) and since they are fixed in nature, they are always treated with the same medicine, thus simplifying treatment. The homeopathic approach to the remaining pathic diseases could then more easily be used. Although modern homeopaths sometimes suggest that their art is especially effective against chronic diseases, Hahnemann himself recognized that homeopathy, like conventional medicine, has more difficulty with these than with acute sicknesses. In response, he developed his theory of miasms, which are supposed to cause all chronic disease (apart from that due to orthodox medicine or to faulty living habits). Hahnemann identified three types of miasm: syphilitic, sycotic, and psoric. Rajan Sankaran have extended this list. Constantine Hering developed the psora doctrine by propounding that symptoms developed in a particular way: * from less vital to more vital organs * from the surface to the interior * from the extremities to the upper part of the body As the patient is cured, the symptoms are said to be relieved (or to temporarily reappear) in the opposite order. === The law of similars === The first and most important "natural law" expressed by Hahnemann, the one from which homeopathy derives its name, is ''similia similibus curentur''—let like cure like. This means that the appropriate substance to treat a disease is one which induces similar symptoms in a healthy person. Homeopathy uses a wide variety of animal, plant, and inorganic substances, from sodium chloride (a.k.a. table salt) to ''lachesis muta'' (the venom of the bushmaster snake). What symptoms are associated with various substances is determined by homeopathic proving, in which the researcher imbibes the remedy and records all physical, mental, emotional and modal symptoms experienced. A homeopathic repertory is a listing of remedies by symptom, used to determine the most appropriate remedy for a given case. Hahnemann's finding are recorded in Materia Medica Pura. James Tyler Kent Repertory (published 1905) lists about 700 remedies. Today, nearly 3000 remedies are used in homeopathy, of which approximately 150 are considered common. Other homeopaths during and after Hahnemann's time, notably Hering and Lux, further developed remedies such nosodes, which are homeopathic dilutions of the agent or the product of the disease in question. Rabies nosode, for example, is made by potentizing the saliva of a rabid dog. Although Hahnemann himself did not treat for the constitution, using it as a basis for assessing the patient's vitality, later homeopaths, notably from Kent onwards, developed an approach to treatment, trying to get at the essence of a case (often referred to as "essence prescribing) called constitutional prescribing and which focusses on the mental-emotional and physical generals of a case. If symptoms become worse after starting a homeopathic treatment, this is referred to as an aggravation or healing crisis depending on when it occurs. When it occurs in the first few seconds or minutes of ingestion of the remedy, this is considered to be an "homeopathic aggravation," and generally occurs in acute cases or if the dose is too large. The idea of aggravation can be considered a consequence of the law of similars in that the medication initially adds to the symptoms of the disease and only gradually replaces it. If it occurs later, usually within 7-14 days of the remedy in chronic cases, this is considered to be a healing reaction of the body and a sign that the medication is taking effect. In some cases an aggravation does not occur but the symptoms improve immediately or after some time. It is also possible that the symptoms change or old symptoms reappear. Alternatively, the symptoms may be considered a response to the disease by the immune system, which is stimulated by the medication to overcome the damage created by the disease destroyed by the similar medicine. The law of similars is a guiding principle in homeopathy, but calling it a "law" is perhaps misleading. There is no certain way to determine an effective remedy for a patient, and homeopaths will often disagree on the best one in any given case. The homeopath will not use ''all'' the symptoms of a patient, but will decide which are the most ''characterictic''. Even then, there will be hundreds of entries in the repertory with most of these symptoms, and every entry will have symptoms listed that the patient does not exhibit. The lack of definite predictions by the law of similars makes it difficult to test scientifically. There are certainly many apparent counterexamples: aspirin does not produce headaches in healthy people, decongestants do not cause congestion, and penicillin does not cause fever. Nevertheless, some homeopathy advocates have suggested a certain plausibility in cases where the symptom is an adaptive immune response. For example, it is generally accepted that fever or inflammation are induced by the immune system in an attempt to eradicate pathogens, rather than being caused directly by the pathogen. One homeopath (Dana Ullman, MPH) argues that a substance that induces a particular symptom (such as fever), might do so by directly inducing or stimulating that specific immune system response. Such an enhanced immune response could aid the body in fighting disease. However it is also possible that a substance might induce a symptom by causing damage to the body in the same way that a pathogen does; and sometimes an immune response can itself cause damage (for example anaphylaxis). For these reasons, ingesting a substance to induce an immune response could be dangerous. ''See also'': List of common homeopathic remedies === The theory of infinitesimals === The most characteristic—and controversial—principle of homeopathy is that the potency of a remedy can be enhanced (and side effects diminished) by dilution in a particular procedure known as dynamization or potentization. Liquids are successively diluted (with water or occasionally alcohol) and shaken by 10 hard strikes against an elastic body, a process called succussion. Insoluble solids are diluted by grinding them with lactose, a process known as trituration. Homeopathic practitioners believe the vigorous agitation following each dilution transfers some of the "essential property" of the substance to the water, which fits in with the concept of disease as a disturbance in the "vital force" of the patient. The dilution factor at each stage is traditionally 1:10 (D or X potencies) or 1:100 (C potencies). Hahnemann advocated the use of 30C dilutions for most purposes, i.e. dilution by a factor of 10030 = 1060. Some later homeopaths, in particular Kent, have advocated the use of much higher potencies, which can no longer be practically achieved by the traditional method, but require succussion without dilution (Jenichen), much higher dilution factors (LM potencies dilute by 1:50,000 at each stage), or machines which in some way integrate dilution and succussion into a continuous process (Kent). Higher dilutions are generally considered stronger. This is in contrast to conventional medicine and biochemistry, which hold that the effects of a substance are always due to its physical and biochemical activity in the patient's body, and therefore that generally the more of an active ingredient is present in a drug, the more effect (whether positive, negative, or both) it will have. The choice of potency will depend on a number of factors depending on the homeopath. These can range from how deep seated the disease seems to be to how the patient has reacted to previous remedies. As a general (although not exclusive) rule, European homeopaths will use lower potencies than their United States counterparts. Some homeopaths believe that, while lower dilutions may have more of a physiological effect, higher dilutions may have a greater effect on the mental or emotional plane. Some homeopaths have suggested that hormesis, whereby a substance harmful at high doses can become beneficial at low doses, provides a rationale for the Law of Infinitesimals. However such a mechanism could operate only at low dilution factors, and provides no rationale for higher dilutions where no molecules of the original substance remain. == The practice of homeopathy == === History === Hahnemann began developing the homeopathic method after coming upon the idea that "like cures like" while translating a work on malaria. Upon reaching a passage stating that quinine was an effective treatment because it was bitter and astringent, Hahnemann felt this implausible because there were many other substances that were equally bitter yet lacked any therapeutic value. To better understand the effects of quinine, he decided to take it himself and observed that his reactions were similar to the symptoms of the disease it was used to treat. This was the birth of the homeopathic principle and is known as "The First Proving". Hahnemann and his students approached their treatments in a holistic way, meaning that the whole of the body and spirit becomes the focus of therapy, not just the localised disease. Hahnemann himself spent extended periods of time with his patients, asking them questions that dealt not only with their particular symptoms or illness, but also with the details of their daily lives. It is also suggested that the gentle approach of homeopathy was a reaction to the violent forms of heroic medicine common at the time, which included techniques such as bleeding as a matter of course. Homeopathy was brought to America in 1825 and rapidly gained in popularity, partly due to the fact that the excesses of conventional medicine were especially extreme there, and partly due to the efforts of Constantine Hering. Hering developed the psora doctrine by propounding that symptoms always move in a particular way: from the surface to the interior, from the extremities to the upper part of the body, and from less vital to more vital organs. His "Laws of Cure" state that the cure must take place in the reverse order of the appearance of the symptoms (first in, last out). Homeopathy reached its peak of popularity in America in the decades 1865–1885 and thereafter declined due to a combination of the recognition by the establishment of the dangers of large doses of drugs and bleeding and dissent between different schools of homeopathy. Nearly as important as Hahnemann himself to the development and popularization of homeopathy was the American physician James Tyler Kent (1849 – 1921). His most important contribution may be his repertory, which is still widely used today. Kent's approach to homeopathy was decidedly authoritarian and unscientific, emphasizing the metaphysical aspects of Hahnemann's teachings, in particular * insistence on the doctrines of miasm and vitalism, * rejection of modern scientific and pathological knowledge as a guide to prescribing, * emphasis on psychological symptoms in prescribing, and * insistence on the use of very high potencies. Kent's influence in America was somewhat limited, but his ideas were reimported into the United Kingdom, where they became the homeopathic orthodoxy by the end of the First World War. In the 1930s the popularity of homeopathy began to wane, especially in Europe and the United States, partly due to advances in biology and conventional medicine and partly due to a decline in coherence in the homeopathic community. Homeopathy experienced a renaissance in the 1970s that continues to this day. George Vithoulkas, who studied in India, where the homeopathic tradition had remained strong, was instrumental in resurrecting homeopathy in Europe, but this phenomenon must also be seen as part of a general increase in interest in alternative medicine. The ease with which large databases can be manipulated has brought about profound changes in the way homeopathy is practised. Today many homeopaths use personal computers to sift through hundreds of thousands of pages of provings and case studies. Because the information about lesser known remedies is more accessible, it is now more common for homeopaths to prescribe them, which in turn has lead to an increase in the number of new provings. Database technology has also encouraged researchers to reorganize and restructure existing information. For example, Rajan Sankaran has been very influential in placing the use of mineral remedies within the context of the periodic table. ''See also:'' List of important homeopaths === Homeopathy around the world === There are estimated to be over 100,000 physicians practising homeopathy world wide, with an estimated 500 million people receiving treatment. Over twelve thousand medical doctors and licensed health care practitioners administer homeopathic treatment in the United Kingdom, France, and Germany. Since 2001 homeopathy is regulated in the European Union by Directive 2001/83/EC. The latest amendments to this directive make it compulsory for all member states to implement a special registration procedure for homeopathic drugs. In the United Kingdom, as in most countries, homeopathic remedies may be sold over the counter. The UK has five homeopathic hospitals where treatment, funded by the National Health Service, can be obtained. Homeopathy enjoys more official recognition in the United Kingdom than in any other country, largely due to a tradition of royal patronage. The only other countries that come close in this respect are India and Pakistan. Homeopathy has been used in India since the middle of the 19th century and is today a widely practised and officially recognized system of medicine there. India has the largest homeopathic infrastructure in the world in terms of manpower, institutions and drug manufacturing industry. There are 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals. In the United States, homeopathic remedies are, like all healthcare products, subject to regulation by the Food and Drug Administration. However, the FDA accords homeopathic remedies a treatment significantly different from that accorded to other drugs. Homeopathic products are not required to be approved by the FDA prior to sale, not required to be proven either safe or effective prior to being sold, not required to be labeled with an expiration date, and not required to undergo finished product testing to verify contents and strength. Homeopathic remedies have their own imprints that, unlike conventional drugs, do not have to identify their active ingredients on the grounds that they have few or no active ingredients. In the United States only homeopathic medicines that claim to treat self-limiting conditions may be sold over the counter, while homeopathic medicines that claim to treat a serious disease can be sold only by prescription. Neither the American Medical Association nor the American Academy of Pediatrics has an official policy for or against homeopathy. Homeopathy's popularity in the United States is growing. The 1995 retail sales of homeopathic medicines in the United States were estimated at $201 million and growing at a rate of 20 percent a year, according to the American Homeopathic Pharmaceutical Association. The number of homeopathic practitioners in the United States has increased from fewer than 200 in the 1970s to approximately 3,000 in 1996. In Germany, about 6,000 physicians specialize in homeopathy. In 1978 homeopathy, along with Anthroposophy and herbalism, were recognized as "special forms of therapy", meaning that their medications are freed from the usual requirement of proving efficacy. Since January 1, 2004 homeopathic medications, albeit with some exceptions, are no longer covered by the country's public health insurance. Most private health insurers continue to cover homeopathy. In Austria homeopathy has been a recognized part of the medical system since 1983. In Switzerland homeopathy is one of the five classes of complementary medicine. At one time, homeopathic medications were covered by the basic health insurance system, as long as they were prescribed by a physician. This practice ended in June 2005. In Mexico the Instituto Politécnico Nacional (IPN) has a school of Homeopaty since 1936. This school has both bachelor and master degrees. === Diversity === There is, and always has been, considerable diversity in the theory and practice of homeopathy. The major distinction may be between what can be called the pragmatic and the mystical approach, but it should be remembered that there are not two distinct groups, but a spectrum of attitudes and practices. An early advocate of pragmatism was Richard Hughes, while the most influential mystic was James Tyler Kent. The pragmatists tend to be open to "whatever works", whereas the mystics tend to rely on the research of one or more authorities. There is still considerable diversity in both camps because the pragmatists usually define "working" based on personal experience and the mystics use various sources as authorities. The pragmatists tend to see homeopathy as ''complementary'' medicine and are more willing to co-exist with conventional doctors. Many in fact ''are'' conventional doctors. The mystics, some of whom are also conventional doctors, see homeopathy as ''alternative'' medicine and have more confidence that homeopathy can be used effectively against all diseases, with the caveat that many potential remedies have not yet been proven. The pragmatists are more likely to be interested in proving homeopathy in the framework of mainstream science. They will talk about the "memory of water" and stimulation of the immune system. The mystics see less need to justify their methods with conventional criteria. For them, homeopathy acts on a vital force that is, so far, not accessible to science. The pragmatists are more likely to prescribe (relatively) low dilutions in multiple doses, and sometimes use more than one remedy at a time. The mystics often use higher dilutions, but generally prefer a single remedy and sometimes a single dose. In the extreme form, pragmatists will even accept over-the-counter homeopathic remedies, but the mystics will always insist on an individual prescription. The mystics may see themselves as "classical" homeopaths, although the historical accuracy of the term may be questionable. The pragmatists see themselves as "scientific", even though they are not accepted by the scientific establishment. == The appeal of homeopathy == === Clinical Efficacy === Homeopathy is popular among patients and practitioners for several reasons. The most important is that patients have personally found it to be effective or heard from friends, colleagues, and the press of many cases, some of them spectacular, in which a sickness was healed after a homeopathic treatment. Some reinforce their favorable judgement with selective reference to positive scientific reports. Though they are aware that science has found no adequate explanation for the mechanism of homeopathy, they tend to subsrcibe to an empirical view of the matter: whatever works is good enough for them. This pragmatic attitude arguably characterizes most health consumers nowadays, whose main concern is for clinical efficacy rather than scientific sanction of their treatment choice. === Disaffection with the establishment === Another reason that many people embrace homeopathy is that they reject the medical establishment, which is perceived to place too much emphasis on machines and chemicals and to treat the disease, not the person. Homeopathic practitioners do, in fact, often spend much more time dealing with their patients than do conventional practitioners. Furthermore, homeopathic preparations have few if any side effects and are generally much cheaper than conventional medications. == The skeptical view of homeopathy == === Lack of a mechanism === Many scientific skepticism consider homeopathy to be a pseudoscience remnant from the age of alchemy. Others consider the belief in homeopathy to be a form of magical thinking. In fact homeopathy was developed at a time when many of the most important concepts of modern chemistry and biology, such as molecules and germs, were understood poorly or not at all. While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required before accepting the existence of the phenomenon under the motto "Extraordinary claims require extraordinary proof". In Hahnemann's day, many chemists believed that matter was Infinite divisibility#Physics, so that it was meaningful to talk about dilution to any degree. Although the hypothesis of atom#history can be traced back to the ancient Greeks, their actual size was not calculated until 1865 (by Johann Josef Loschmidt). It is now known that there are 6.02×1023 particles in a mole (Avogadro's number), so that homeopathic dilutions greater than about 24X or 12C are virtually certain to contain not even a single molecule of the initial substance. This fact is recognized by advocates of homeopathy, who assert that the essential healing power of their preparations is not found in the chemical action of molecules, but perhaps in the arrangement of the water molecules, giving rise to the expression "the memory of water". This concept is closely related to the belief in a vitalism, which was common in Hahnemann's day, but was slowly given up by the scientific community as more and more life processes came to be describable in purely materialistic terms, and as the medical model of disease came to be more and more focused on the failure of particular organs and processes in the body. This process began with the synthesis of urea by Friedrich Wöhler in 1828. The consensus among modern scientists is all of chemistry and biology can ultimately be explained ''in principle'' by the basic interactions of molecules, even if many processes are far too complex to be understood at this time. In short, the skeptic sees no evidence of a plausible mechanism by which homeopathic dilutions can possibly act. Closely related to the question of the mechanism is, in the eyes of critics, logical inconsistencies in the theory. The theory assumes that water is imprinted by the properties of molecules that it once came in contact with, even when the molecules are diluted away. If this were so, then where did the pure water used in this process come from? The water that homeopaths themselves use was once in contact with other chemicals, including chemical wastes, radioactive metals, dinosaur urine, and various poisons. According to this skeptical interpretation of homeopathic theory, all water in the world should remember its contact with millions of chemical substances and not just the properties of the chemicals that the homeopath claims will be useful. The answer of the homeopaths, that dynamization involves succussion as well as dilution, is not satisfying, first because it seems improbable that one can amplify order in a solution by shaking it, secondly because a lot of shaking goes on in the natural world as well. Why does a waterfall not dynamize the substances dissolved in the stream? It is not possible to prove that no consistent theory of potentization exists, but none is obvious and advocates have not been able to produce one. Homeopaths occasionally invoke the unusual properties of water to explain the memory effect. In addition to the problems above, a theory of homeopathy would also have to explain why dynamization works not only with water but also with alcohol and lactose, which have very different properties. Even if a homeopathic preparation somehow preserves information from the original substances, there is absolutely no plausible mechanism by which that should effect a cure. === Lack of evidence for therapeutic efficacy === Most of the published studies into homeopathy are of poor scientific quality, and that the higher quality studies tend to report less positive results., A 2003 evaluation of the whole of homeopathic research over the previous 10 years reported: :RESULTS: Clinical studies and in vitro research indicate the inefficacy of homeopathy. Some few studies with positive results are questionable because of problems with the quality and lack of appropriate experimental controls in these studies. The most recent meta-analyses on the topic yielded negative results. One of the few previous meta-analyses with positive results had serious publication bias problems, and its results were later substantially reconsidered by the main authors. The sparse in vitro homeopathic research with positive results has not been replicated by independent researchers, had serious methodological flaws, or when replicated, did not confirm the initial positive results. A plausible mechanism for homeopathic action is still nonexistent, and its formulation, by now, seems highly unlikely. :CONCLUSIONS: As a result of the recent scientific research on homeopathy, it can be concluded that ample evidence exists to show that the homeopathic therapy is not scientifically justifiable. Skeptics point out that there are very few studies that meet the highest standards of scientific research, and there is a tendency for the better studies to show less effect. Many high quality studies have been published that showed no effect. The few high quality studies that show a positive effect could be the result of statistical fluctuations, that is, if many studies are made, some will by chance appear to support homeopathy. The situation is aggravated by publishing bias—A positive result will probably be published but a negative result is more likely to be suppressed by the initiators of the study, or not written up by the researchers, or rejected by the referees or editors of the journals. The skeptics tend to reject the evidence of any study that is not double-blind, randomized, and placebo-controlled, since it has been shown many times that the results can otherwise be biased by the placebo effect, or through post hoc reasoning applied to the regressive fallacy. Skeptic James Randi has offered an award of one million dollars (U.S.) to anyone who can prove the existence of anything supernatural or paranormal. The million dollars is also available to anyone who can, by any means of their choosing, tell the difference between plain water and any homeopathic remedy of their choosing. A recent attempt to win the prize was aired on the BBC science program ''Horizon (television)''. This test, like all others to date, failed. Having concluded that the controlled studies of homeopathy are too weak to be convincing, the skeptics must still address the widespread reports of successful treatments. They begin by pointing out that anecdotal evidence of controversial phenomena is nearly useless as scientific evidence. Without control cases, it is impossible to distinguish between efficacy of a treatment and spontaneous remission. Without double blinding it is impossible to rule out observer bias and the placebo effect. Without reproduction in a separate study, it is difficult to rule out chance, fraud, or poorly understood systematic effects. === Homeopathy may not be completely harmless === The skeptical view is that homeopathic dilutions have no direct effect at all, so the skeptic naturally will not claim that the remedies themselves have any harmful side effects. The main potential harm from homeopathic treatment, therefore, arises not from the remedies per se but from the withholding of arguably more efficacious treatment or from misdiagnosis of dangeous conditions (a general criticism that can be applied in any situation of negligent practice due either to medical negligence or the proferring of medical opinion by the non-medically qualified). Moreover, even proponents of homeopathy caution that improper homeopathic treatment of conditions such as asthma, eczema, and penumonia can cause harm. == The applicability of traditional scientific procedures == While skeptics tend to reject borderline results from scientific studies because they are, due to the lack of a plausible mechanism, predisposed to believing that there can be no effect, proponents of homeopathy tend to accept these results due to the opposite predisposition based on their personal experience. In addition, they criticize an unwillingness of the establishment to invest the resources needed to test their hypothesis more thoroughly and what they see as weaknesses in the traditional methodologies. It is often said that homeopathy cannot be tested in objective studies because it is a principle that each patient and each illness be treated individually and an emotional doctor-patient bond is necessary for successful treatment. Aside from the fact that homeopathy is often not practiced this way, with many patients taking over-the-counter preparations according to the recommendations on the label, this objection has no sound basis. While it may be difficult to objectively study some aspects of homeopathic treatment, e.g., the role played by the relationship between practitioner and patient, the efficacy of homeopathic preparations in high dilution is easily studied. One could, for example, let a practitioner prescribe whatever he wants for whatever patients come to him, and then give half the patients authentic homeopathic preparations and the other half plain water, alcohol or sugar. If the two groups cannot be distinguished at a statistically significant level on the basis of the judgement of the practitioner, the reports of the patients, or objective medical tests, then the hypothesis of efficacy can be rejected. Rather than insist that all studies be double-blind and randomized, some proponents of homeopathy downplay the importance of the placebo effect by pointing to reports of successful treatment of infants and animals. Scientists answer that even in these cases double-blinding is necessary because (1) the rate of spontaneous remission must be determined, (2) the person evaluating the healing can be influenced by knowing which subjects received the active treatment, and (3) the subjects can respond to the expectations of the person administering the treatment. == Misconceptions about homeopathy == === Composition of homeopathic remedies === Many producers of homeopathic remedies also produce other types of alternative remedies, under the same brand name, which can create some confusion for the general public. A common misconception is that homeopathic remedies use only natural, and thus presumed by some to be safe, herbal components (akin to herbology. While herbs are used in homeopathy, there is also use of non-biological substances (such as salts) and components of animal origin, such as duck liver in the popular remedy oscillococcinum. Homeopathy also uses substances of human origin, which are called ''nosodes''. Another difference is that though both do use herbs, in herbology measurable amounts of the herb(s) are in the remedy, while in homeopathy the active ingredient is diluted to the point where it is no longer measurable. Some people have the opposite misconception, that homeopathic remedies are only based on toxic substances like snake venom or mercury. Since the term homeopathy is well known and has good marketing value, the public can be further confused by people who have adopted the term for other forms of therapy. For example, some companies have combined homeopathic remedies with less benign substances. Classical homeopaths claim only remedies prepared and prescribed in accordance with the principles established by Hahnemann can be called homeopathic. === Homeopathy and vaccination === The practice of mainstream medicine that most closely resembles homeopathy is vaccination. The vaccine must be closely related to the disease against which it is to protect and must be given in a very small dose to be effective. These characteristics are reminiscent of the law of similars and the law of infinitesimals. In fact, Hahnemann himself interpreted the introduction of vaccination by Edward Jenner in 1798 as a confirmation of the law of similars. Modern homeopaths view vaccination and homeopathy as fundamentally different. Although Hahnemann originally introduced low dosages in order to reduce side effects, he later believed, as do most homeopaths today, that remedies are most effective if they have been dynamized to such a degree that they have no direct chemical effect. From this point of view, the need to keep the dosage of vaccine low is simply the standard requirement to avoid consuming an excessive amount of any conventional drug. The dosage of a vaccine is still much higher than typical homeopathic dosage, and the vaccine has been diluted but not dynamized. Homeopathic critics of vaccination also consider the resemblance to the law of similars to be superficial. In most cases a vaccine is not intended to ''cure'' a disease at all, but rather to ''prevent'' it by preparing the immune system of a healthy organism to meet an attack by a pathogen in the future. Furthermore, the vaccine is usually a bacterium or virus whose capability to produce symptoms has deliberately been weakened while still providing enough information to the immune system. The "similarity" of the vaccine and the disease in terms of symptoms is thus reduced. The difference between homeopathy and vaccination is best illustrated by a comparison with nosodes, which are made from ''active'' (not deactivated) pathogens, are applied ''after'' the onset of a disease to ''cure'' it (not before to prevent it), and are administered at ''zero'' (not merely low) dosage in a chemical sense. == References == #[http://www.homeopathic.com/articles/intro/immune_system.php Homeopathic Medicine and the Immune System] by Dana Ullman #[http://www.accampbell.uklinux.net/homeopathy/homeopathy-html/chapter08.html ''Kentian Homeopathy''], Chapter 8 of ''Homeopathy in Perspective'' by A. Campbell #[http://www.thespiritofhomoeopathy.com/evolution.html The Evolution of Homoeopathy] #[http://www.dw-world.de/dw/article/0,1564,1575855,00.html Homeopathy Seeks More Acknowledgement] from Deutsche Welle #[http://www.delhihomeo.com/paperberlin.html Cost Effectiveness and Efficacy of Homeopathy in Primary Health Care Units of Government of Delhi- A study] by Dr. Raj Kumar Manchanda and Dr. Mukul Kulashreshtha #[http://www.dhu.de/wc_800/archiv/GMG.shtml Gesundheitssystem: Was bringt das neue Gesetz?] (in German) #[http://www.findarticles.com/p/articles/mi_m2843/is_6_25/ai_79794372 Magical Thinking in Complementary and Alternative Medicine] from the Skeptical Enquirer # Klaus Linde and Dieter Melchart "Randomized Controlled Trials of Individualized Homeopathy: A State-of-the-Art Review", ''Journal of Alternative and Complementary Medicine'' 4 (1998): 371-88 ([http://nhscrd.york.ac.uk/online/dare/990167.htm structured abstract]) # M. Cucherat ''et al''. "Evidence of Clinical Efficacy of Homeopathy: A Meta-Analysis of Clinical Trials", ''European Journal of Clinical Pharmacology'' 56 (2000): 27-33 ([http://nhscrd.york.ac.uk/online/dare/20001151.htm structured abstract]) # [http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812003000600007&tlng=es&lng=en&nrm=iso A critical review of the possible benefits associated with homeopathic medicine], Renan Moritz V. Rodrigues Almeida, ''Rev. Hosp. Clin.'' vol.58 no.6 São Paulo 2003 #[http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml Homeopathy: The Test - programme summary] from BBC == External links == === References === * Online etext of Hahnemann's ''Organon der Heilkunst'': [http://www.homeoint.org/books4/organon/ German original] and [http://www.homeopathyhome.com/reference/organon/organon.html English translation] === Even-handed === *A recent article on homeopathy testing from the [http://www.annals.org/cgi/content/full/138/5/393/ Annals of Internal Medicine] * [http://www.bbc.co.uk/science/horizon/2002/homeopathy.shtml BBC's ''Horizon'' on homeopathy] (transcripts, discussion, etc.) * [http://www.acampbell.org.uk/homeopathy/index.html Homeopathy In Perspective] — critical online book, covering the history and present state of homeopathy * [http://www.fda.gov/fdac/features/096_home.html FDA's view of homeopathy] === Supportive === * [http://www.arnica.com/homeo/homeo.html Introduction and Information on Homeopathy] * [http://www.homeopathy.org/ North American Society of Homeopaths] * [http://www.holisticmed.com/www/homeopathy.html Extensive Homeopathy Links from The Holistic Medicine Resource Center] * [http://www.hpathy.com/ Information and Discussion Forum] * [http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_homeopathy.shtml Complementary Medicine - Therapies: Homeopathy] BBC's "Complementary Medicine" article on Homeopathy *[http://www.homeopathy-cures.com/html/referrals_to_homeopaths.html Referrals to Certified Classical Homeopaths] * [http://www.a-r-h.org Alliance of Registered Homeopaths] * [http://www.homeoint.org/english/index.htm Homéopathe International] — The English language version of ''Homéopathe International'' * [http://www.wholehealthnow.com/homeopathy_pro/homeopathy_1825_1849.html Homeopathy Timeline] with a wealth of historical and biographical information === Critical === * [http://www.randi.org/jr/02-02-2001.html A skeptic's view of homeopathy] * [http://www.csicop.org/si/2001-11/alternative.html Magical Thinking in Complementary and Alternative Medicine] * [http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.html Quackwatch on homeopathy] * [http://www.homeowatch.org/ HomeoWatch] — A Skeptical Guide to Homeopathic History, Theories, and Current Practices, operated by Stephen Barrett, M.D. (founder of Quackwatch) * [http://www.bbc.co.uk/dna/h2g2/alabaster/A954740 H2G2 entry on homeopathy]. * [http://www.skepdic.com/homeo.html The Skeptics Dictionary] * [http://www.acsh.org/search/txtQuickSearch.homeopathy/health_result.asp "The Scientific Evidence on Homeopathy"] - American Council on Science and Health *[http://www.skepticreport.com/health/hahnemann.htm A close look at homeopathy] *[http://www.skepticreport.com/health/dilutiondelusion.htm Dilution or Delusion?] *[http://www.ncahf.org/pp/homeop.html National Council Against Health Fraud Position Paper on Homeopathy] Homeopathy Alternative medical systems Professional CAM treatments Alternative medical treatments derived from western culture Pseudoscience
Homeopathy
==Previous discussion archive== Previous discussions are archived here. *Talk:Homeopathy/Archive 1 *Talk:Homeopathy/Archive 2 *Talk:Homeopathy/Archive 3 *Talk:Homeopathy/Archive 4 =="Controversial" - A simple compromise - I hope...== I'm changing the intro paragraph so that it notes that homeopathy is controversial, and it notes that it's "alternative medidicine." But it will not include the phrase "controversial system of alternative medicine," so as to avoid the adjective "controversial" been misread as a modifier of "system of alternative medicine," which would imply that it's more controveral that other forms of alt. medicine. Hopefully this will work for everyone. Intro paragraph: :Homeopathy (also spelled homœopathy or homoeopathy), from the Greek language words ''homoios'' (similar) and ''pathos'' (suffering), is a system of alternative medicine, notable for its use of remedies without chemically active ingredients. The theory of homeopathy was developed by the Saxony physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but is controversial because its principles are contrary to accepted scientific methods and to the principles of conventional medicine. User:Blackcats 04:31, 2 Jun 2005 (UTC) :It's inadequate to say that homeopathy is controversial simply because, under well-established principles, it can't possibly work. The experimental results are also important, and were alluded to in the earlier version. At any rate, your attempted compromise has now been replaced by a rapidly pro-homeopathic version. As long as the devotees of homeopathy keep trying to turn this article into a commercial for their particular brand of quackery, the edit warring will continue. (Mind you, I'm not trying to get the article to ''state'' that homeopathy is quackery. We don't answer one violation of the NPOV policy by substituting another.) User:JamesMLane 05:39, 3 Jun 2005 (UTC) James - the attempted compromise which I edited the article with was a very slightly modified version of what you yourself proposed: :Also, for clarity, I think this lead section should be broken into two paragraphs, and I've made some wording changes from your version (I didn't like "scientific notions", for example). So what about this version: ::Homeopathy (also spelled homœopathy or homoeopathy), from the Greek language words ''homoios'' (similar) and ''pathos'' (suffering), is a controversial system of alternative medicine, best known for its use of certain remedies that are so highly diluted as to have no chemically active ingredients. The theory of homeopathy was developed by the Saxony physician Samuel Hahnemann (1755–1843) and first published in 1796. It has a wide and growing popularity in areas where it is practiced today, but its principles are contrary to accepted scientific beliefs as well as to the principles of conventional medicine. ::Homeopathy essentially treats "like with like". The patient describes his or her symptoms in detail. The practitioner considers the physical and psychological symptoms to determine the image of the disease in the patient. The practitioner then prescribes extremely small, nontoxic doses of a substance thought to match the disease image or complex in the patient. :User:JamesMLane 23:18, 17 May 2005 (UTC) I simply replaced "scientific beliefs" with "scientific methods" and moved the "controversial" so that it wasn't directly modifying the phrase "alternative medicine." For the record, I'm no fan of homeopathy, and I do feel that it's more dubious than other forms of alt. medicine, but I didn't feel that Wikipedia should assert that as such. Instead it should present the objective facts and let people come to their own conclusions. Furthermore, the fact that some annonomous IP users (who for all we know could be straw-man internet sock puppets) have been ''vandalizing'' the page should have no bearing on any negotiations or attempts at compromise between good faith editors like you and I. --User:Blackcats 20:22, 3 Jun 2005 (UTC) :The last sentence of the above rewrite is not exactly accurate nor does it make much sense. I'd suggest the following: "The practitioner then prescribes a substance which is considered to produce a similar disease image in healthy persons ("provings"), usually in very dilute doses. --User:Rudiverspoor 03:25, 4 Jun 2005 (UTC) ::Blackcats, I agree that the pro-homeopathic editors can't be considered as a monolithic bloc. My point was only that, although I was hopeful that we were making progress toward a consensus version, we have no hope of reaching stability if people come in and make edits like the one the anon made. Also, I don't necessarily agree with everything that was in a prior edit, even one of my prior edits! I think I used the term "beliefs", but then Jooler pointed out, correctly, that this conveyed an inaccurate picture of scientific conclusions (because science isn't a belief system, unlike homeopathy and religion). :::And that's why I changed "beliefs" to "methods." I'm sure most every scientist would be happy with that wording. That's one of the first things we went over in most of the science classes I've taken - the scientific method. User:Blackcats 19:46, 5 Jun 2005 (UTC) ::My problem is with flatly asserting that homeopathy is a form of alternative medicine. For treating cancer, chemotherapy, radiation, and surgery are forms of medicine. Crystal healing and the like is not a form of medicine. That's why I wanted to qualify that assertion by including the word "controversial". If that's a problem, I'd be OK with the more direct statement if it's attributed as an opinion, rather than being asserted: "Homeopathy is said by its practitioners to be a form of alternative medicine...." Would that raise fewer hackles than the word "controversial"? User:JamesMLane 05:06, 4 Jun 2005 (UTC) :::James, you seem to be saying that homeopathy is not a form of alternative medicine. If you read the alt medicine article I think you'll see that homeopathy falls well within the accepted definition. --User:LeeHunter 13:44, 4 Jun 2005 (UTC) ::::I agree with User:LeeHunter. If you want to argue that alternative medicine is inherently a misnomer, then you should fight it out over there. Once you change the name of that article to controversial medicine or alternatives to medicine or whatever, then we will be happy to change the wording here. Until then, we have other bones to pick. User:Art Carlson 16:42, 2005 Jun 4 (UTC) :::::I do think that the phrase "alternative medicine" is a masterpiece of deceptive marketing, but I agree that that's beyond the scope of this article. My only point was to explain why I favored the wording "a controversial system of alternative medicine". Rudi suggested above that saying it's alternative medicine establishes that it's controversial. I disagree, because not everyone knows enough about the field to know that anything called "alternative" is controversial. We should certainly use the phrase "alternative medicine" and wikilink it, but we should include "controversial" so the reader is notified of that key point without having to read the other article. User:JamesMLane 23:02, 4 Jun 2005 (UTC) ::::::And that was the whole point of my compromise! We would be explicitly stating that it was controversial in the first paragraph, but we wouldn't use wording (at least not in that first paragraph) that could be read to mean that it was more (or less) controversial that other forms of alt. medicine. User:Blackcats 19:40, 5 Jun 2005 (UTC) Why say it's a "system of *alternative* medicine"? Wouldn't it be more accurate to state that it's simply a "system of medicine". This would then cover all the families and communities for whom Homoeopathy is the only system of medicine and not an alternative. And why *controversial*? There are two sides to every controversy, which means that all allopathy-related articles would also have to be re-edited and described as *controversial* too. Or is Wikipedia intended as a partisan resource? == Scientific Criteria == Could someone explain to me what are the minimum criteria referred to in the intro paragraph? This seems to me to be different and more radical from stating that it goes counter to current principles of science. --User:Rudiverspoor 03:32, 4 Jun 2005 (UTC) I would also like some clarification of how homeopathy goes counter to the scientific method, rather than to current principles held, based on the following dictionary definition: :The principles and empirical processes of discovery and demonstration considered characteristic of or necessary for scientific investigation, generally involving the observation of phenomena, the formulation of a hypothesis concerning the phenomena, experimentation to demonstrate the truth or falseness of the hypothesis, and a conclusion that validates or modifies the hypothesis. --User:Rudiverspoor 03:37, 4 Jun 2005 (UTC) ::One variation of the language that we've used (the one in the article as I write this) is that "neither its empirical nor its theoretical foundation meets the minimum criteria of the scientific establishment." ::*The theoretical objection is that there is no known mechanism for "water memory" or anything else that could produce an effect in the absence or virtual absence of active ingredients. The phrase "no known mechanism" can be misleading. Homeopaths seem to be found of saying that science doesn't know everything. That's true, but scientists have some idea of what they know and what they don't know. Perpetual-motion machines would violate conservation laws that have held up in a wide variety of circumstances. It's conceivable that there's someplace in the universe where conservation laws are violated because hydrogen atoms are popping into existence, but it's very unlikely that conservation laws are violated by some collection of capacitors, conveyor belts, and old mufflers that Uncle Elmo assembles in his garage. Similarly, the point about "no known mechanism" is that these sorts of chemical reactions have been studied intensively for many years under many different conditions. It's kind of like saying there are no known unicorns. We not only haven't seen them, but we have good reason to think that, if they did exist, we would have seen them by now. ::*The empirical objection is that, in more than two centuries, homeopaths have failed to come forward with any hypotheses that have been tested and found to hold true. Reproducible results are very important to the scientific method. Given that there have been many tests, it would be expected that some of them, by chance, would suggest a healing value beyond the placebo effect. The overall results of the testing, however, have been more consistent with the hypothesis of rejecting homeopathic claims. ::I don't think the lead section (or any other) should assert that homeopathy is bunk, but I think those two points of the criticism are each worth at least a mention in the lead. (This formulation of the skeptical view seems more accurate to me than one that invokes "the scientific method".) The elaboration of these criticisms, along with the elaboration of homeopathic claims and homeopaths' responses to the criticisms, is of course left to the body of the article. User:JamesMLane 04:49, 4 Jun 2005 (UTC) ==Definition of Remedy== According to answers.com *Remedy - ''Something, such as medicine or therapy, that relieves pain, cures disease, or corrects a disorder.'' **Since I don't believe that homeopathically treated water does relieve pain, cure disease or correct disorders, I object to the use of this word in the opening paragraph. User:Jooler 18:14, 4 Jun 2005 (UTC) :A placebo is also a remedy and often work as well as many conventional medicines. You can argue whether or not homeopathy works better than a placebo but you cannot dispute that it works as well as a placebo. In other words that in some cases pain is relieved, diseases cured and disorders corrected. --User:LeeHunter 18:50, 4 Jun 2005 (UTC) :that isn't the defintion of a homeopathic remedy though.User:Geni 19:46, 4 Jun 2005 (UTC) :Conventional medicines are not approved unless they work ''better'' than a placebo. User:Art Carlson 20:46, 2005 Jun 4 (UTC) ::That's true (at least in theory) but it doesn't really have anything to do with the point being disputed. Conventional doctors also prescribe placebos. I note that the remedy article indicates that nowadays the word is more typically applied to herbal medicine than pharmaceuticals. --User:LeeHunter 22:39, 4 Jun 2005 (UTC) :A placebo is not a remedy. Placebos do not in and of themselves "relieve pain, cure disease, or correct a disorder" - that is the action of the mind. Certainly the use of the word remedy might now more readily apply to herbal concoctions rather than pharmaceuticals. But I still dispute that the word ''remedy'' can readily applied to something which I believe that does not actually have any remedial properties whatsover. User:Jooler 11:13, 5 Jun 2005 (UTC) ::You can relieve pain or cure a condition by something you do (taking a vacation) or something you think (mother doesn't hate me after all). The fact that the healing action takes place in the mind is an interesting side note, but doesn't alter the fact that the healing was triggered by taking the little white pill, having psychotherapy or going on holiday. Aside from all this pedantic and semantic stuff, "remedy" is the specific term that homeopaths use. Unless there's a compelling reason, I think we should keep using it. And one final note, homeopaths have millions of satisfied clients like myself, people who will tell you that conventional medicine and other forms of alternative medicine did nothing (or made things worse or caused other problems) whereas homeopathy simply provided a safe, inexpensive and permanent cure. Perhaps, since 'science' says homeopathy can't possibly work, we're all just delusional, but when it comes to deciding whether something is or isn't a "remedy" I think the opinions of the actual patients should count for something. --User:LeeHunter 13:24, 5 Jun 2005 (UTC) :::That hits the nail on the head. There are millions of people that think homeopathy works because they were sick, they took a homeopathic preparation, and then they were better. A scientist is trained to ask critical questions about this hypothesis. Are there also people who were sick, took a homeopathic preparation, and didn't get better? Are there also people who were sick, didn't take a homeopathic preparation, and got better anyway? How many people were in each of these groups? With what accuracy can I determine these numbers? If more people really do get better after taking a homeopathic preparation, is it the result of something in the pill or something else that happened? Could there be reasons that people say they got better when they really did not? Could an observer sometimes conclude people get better when they really do not? How can I design a study to rule out as many of these possible confusing factors as possible? I don't mean to denigrate the opinions of satisfied customers of homeopathy, but if you are interested in what is ''really'' going on, their opinions "count" less than the few good studies which have been made. User:Art Carlson 14:08, 2005 Jun 5 (UTC) ::::But you're mixing up several issues here. The question of whether homeopathy performs better or worse than a placebo in clinical trials is one question. Whether "remedy" is the appropriate word for a substance used in homeopathy is another. I recognize that one of the reasons that 'remedy' has fallen out of favor in conventional medicine (in favor of more neutral terms like drugs, pharmaceuticals etc) is that, to a scientist, the word does imply a positive outcome and therefore doesn't lend itself to the world of double-blind studies etc. But whether it actually works better or the same as a placebo has nothing to do with the how the word "remedy" is commonly used in the English language and especially within homeopathy. Even within homeopathy, it's difficult to find the "right" remedy. Sometimes a homeopath will try many remedies and not find one that produces an effect. Even when it obviously doesn't work, the stuff in the bottle is still known, to patient and doctor, as a "remedy". --User:LeeHunter 15:11, 5 Jun 2005 (UTC) :::::You're right, I got sidetracked. I apologize. As to the issue at hand, I personally have no problem with using the word "remedy" in the sense of "intended to remediate". On the other hand, there must be synonyms, maybe "preparation", that would satisfy everybody. User:Art Carlson 20:09, 2005 Jun 5 (UTC) :With regard to the use of the word ''remedy'' I think my re-wording now satisfies my concern, it no longer states that homeopathic products are remedies, merely that homeopaths consider them remedies. With regard to the other issue, Art makes the point eloquently, do homeopaths really want to know what is going on when someone reports the success of a homeopathic treatment, or are they just in the business of quakery and exploiting people. Sine scientia ars nihil est. User:Jooler 16:27, 5 Jun 2005 (UTC) ::A good homeopath works like a good doctor. Both are focused on helping the patient improve. They operate from different models, have different standards of wellness and use different bodies of knowledge but the focus is on whether the patient is better or worse. Bad doctors, and I've seen a few of those, ignore the patient and rely on the 'science' even in the face of contrary reports from the patient. You like to characterize homeopaths as near criminals exploiting the gullible. There are definitely many poor homeopaths out there (and given the lack of standards there are unquestionably more bad homeopaths than there are bad doctors) but there are also many who are sincere, modest and extremely knowledgable (quite a few are also MDs). The best homeopaths (I'd count my own homeopath in that group) have skills of observation and analysis which are superior to any doctor I've met. So, in answer to your question, homeopaths do want to know what is really going on when a patient reports improvement. Like any good doctor, they don't much care whether or not the improvement fits the current state of science, only whether it is real and whether it is lasting. One key difference though, is that homeopaths are completely focused on deep and lasting cures. For example, if someone has a recurring rash a regular doctor will generally prescribe an ointment or antibiotics to control the symptoms. A homeopath, on the other hand, would find that approach appalling and wouldn't be satisfied until they found a "remedy", something that solved the problem permanently. --User:LeeHunter 17:30, 5 Jun 2005 (UTC) :::evidence?User:Geni 20:46, 5 Jun 2005 (UTC) ::::Of what? --User:LeeHunter 21:57, 5 Jun 2005 (UTC) :::::of suppression, that homeopaths can cure anything beyond the placebo effect, that genus epidemicus is not part of homeopathy and that individulisation is real. For your stament to be correct you need to be able to provide evidence for all of the above. :::Your choice of a rash as an example is an interesting one. A rash is very often a symptom of something more profound, like an allergy or a deficiency or an emotional problem or a more chronic illness. As a senior software designer working with more junior colleagues I often find that that they try to patch up a bug by working around it, for example if a function consistently returns a value one less than it should (the off by one error is not uncommon in software) they might simply add 1 to the result. This is a simplification, but it illustrates the point. My response to this kind of patching up is to state -- "you are treating the symptoms and not the disease". If a doctor prescribes ointments etc.. without looking more deeply at the reasons for the condition, then they are also guilty of treating the symptoms and not the disease. For a homeopath, a patient has a cough, what does he do? - he prescribes a solution made (before dilution) from a substance that would induce coughing. The supposed "holistic" approach of homeopaths is a myth. Even if they were prescribing products that were known to cure they are only aiming to treat the symptoms, just like a bad doctor. I find your bald statement "there are unquestionably more bad homeopaths than there are bad doctors" very illuminating. User:Jooler 22:10, 5 Jun 2005 (UTC) ::::I'm afraid you only have the most superficial idea of how homeopathy works. In your view: "This stuff makes people cough so if we dilute it, it will fix a cough." That is not what happens at all. It's almost unavoidable that people get that impression if their only exposure to homeopathy is through articles like this, but it's completely wrong. There are probably hundreds of remedies that include "cough" as just one of hundreds of data points. And then the cough is only piece of a huge picture that covers the patient. The homeopath (a good one anyway) will spend a long time getting to know the patient on a deep level (often going back to childhood), organize the patient's story into themes and patterns, sift through a staggering quantity of information and sort through thousands of remedies to try and find the one that exactly fits the patient like a cryptographic key. If he or she hits the right one, not only the cough will improve, but anything else that is wrong with the patient should also disappear (sometimes it takes a combination of remedies over time). Contrast that with the way your family doctor works. "Gee that's a nasty cough! Here try this new cough suppressant the Bristol-Myers guy dropped off this morning along with tickets to that big conference in Thailand!" --User:LeeHunter 22:43, 5 Jun 2005 (UTC) :::::Nice strawman about conventional medicine. Now a homeopath may do all that but we know that hahnemann was prescibeing sulphur an incredibly large amount of the time[http://www.otherhealth.com/showthread.php?t=5122]. If you ever look through a list of what most homeopaths prescribe it's the same remedies again and again arnica, nux vom, the so called polycrests. There may be thousands of homeopathic remedies but I doubt more than 30 or so are used with any real regularity (I doubt it is even that high but no matter).11:03, 6 Jun 2005 (UTC) ::::::Speaking of strawmen, why do you always go back 250 years to try and disprove what homeopathy is doing today? There are still a few homeopaths who think that Hahnemann is the last word but, like everything else in the world, most have moved on. One could also say that conventional medicine is rubbish because at the time of Hahnemann surgeons didn't wash their hands. Its nonsensical. Regarding your doubts about how many remedies are commonly used, I can assure you that a good homeopath does work from a repertoire of thousands of remedies and will frequently prescribe the so called small remedies. I myself was given one of the more esoteric, recently proved remedies and the effect was striking. Perhaps it was still a 'placebo' but it makes me wonder why doctors and other forms of alternative medicine weren't able to provide such an amazing "placebos". Of course, the more well-known remedies are no doubt prescribed more frequently, but that's hardly informative. Your average doctor prescribes antibiotics for conditions that he knows aren't treatable by antibiotics. It doesn't mean antibiotics don't have their place or that lesser known pharmaceuticals are not used. --User:LeeHunter 11:31, 6 Jun 2005 (UTC) :::::::it is no longer considered ethical for doctors to prescribe placebos. Trying to get hold of treament records for modern homeopaths is difficult without resorting to theft.User:Geni 17:44, 6 Jun 2005 (UTC) A 'remedy' in Homoeopathy is a potentized medicine - prepared as Hahnemann describes - that has been prescribed correctly and is therefore acting curatively. Unless and until it is applied in this way it remains a potentized medicine. :No that woruld be the clasical defintion which is far from universal.User:Geni 10:34, 10 Jun 2005 (UTC) == NPOV tag == What points are open that require the NPOV tag (which, if I follow correctly was introduced by Geni), as opposed to the normal editorial differences? User:Art Carlson 20:58, 2005 Jun 4 (UTC) :none that I know of. You may want to ask Leifern or Rudi.User:Geni 21:29, 4 Jun 2005 (UTC) ::Sorry, I've been off for a while, but you guys seem to have been having a good discussion. For now, the lead part seems a very workable draft as we develop the body of the article. --User:Rudiverspoor 01:54, 8 Jun 2005 (UTC) == Some specific controlled studies and clinical trials == Hello, Geni,
Don't you think you might have compressed some useful information away in the introductory sentences to this section?([http://en.wikipedia.org/w/index.php?title=Homeopathy&diff=15225682&oldid=15225599 diff]) I don't really know what your objection is, either, since your reference [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14] seems to be to a pay site. At least I just get the cryptic title ("Malathion A and B esterases of mouse liver-I") of a paper from 1975. I agree that my paragraph is probably out of place here, but I think it should be incorporated into the section ''4.2 Lack of evidence for therapeutic efficacy'', rather than deleted.
More generally, I would like to find and briefly analyze the best 2 or 3 studies in each of these categories and/or the best 2 or 3 ''positive'' studies. What I am after is a well-informed and transparent basis for judging the quality of the evidence. This task is not too easy because the proponents of homeopathy don't seem to agree on what their best evidence is. I hope you can help with this.
User:Art Carlson 13:01, 2005 Jun 15 (UTC) :Try here for a reference[http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812003000600007&tlng=es&lng=en&nrm=iso]. The problem is that the over the last few years there has bene a lot of negative reaseach into homeopathy. Before then the balance probably in favor of homeopathy although the quality of studies ranged between poor and appalling. The link was not to the most complete list of studies of homeopathy around (in fact it was to an extreamly short list of studies. The true total is around 100). In terms of anaylising studies there are only three studies that I know of that follow sciencific protocols and full homeopathic ones (although there are a few more that follow the methods of homeopathy that are often used in practice). Two of them are already in the article the third is [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11316508&query_hl=13] User:Geni 13:44, 15 Jun 2005 (UTC) ::Thanks a lot, Geni. Your first reference is very enlightening. It leaves me with the question of what to do with this section. I created it originally as a catch-all for details that were cluttering the main article when I was reorganizing it. I thought it would be useful either, like I said, to give an informed basis for evaluating the quality of the evidence, or to answer proponents who say, Well what about the study by so-and-so proving such-and-such? After reading the review cited, I have grown faint of heart at the idea of in any way doing justice to the quality and quantity of recent research. And we haven't heard much from proponents pushing any particular research results. (I am left with the impression that they are not that interested in science. I guess otherwise they would not be proponents.) So the radical question is: Do we need this section at all? We can put a few uncompromising summary statements into the "skeptical" sections and link to the review for those interested in the details. What do you think? What do our resident homeopaths think? User:Art Carlson 08:53, 2005 Jun 16 (UTC) :::homeopaths do have some interest in science but most of them are not to0 worried about it. Danna ullman was probably the last to really try and make the case that homeopathy had been proved scientificaly and his book is getting dated. Other than that there is the reseach funded by boiron into ultra molecular trials. Since we have no idea about publication bias in this area (although there are reasons to suspect it is quite high) it is a bit difficult to come to solid conclusions in this about this work.User:Geni 12:22, 16 Jun 2005 (UTC) ::::Is the scientific case strong enough to move the section on "Lack of evidence for therapeutic efficacy" from "The skeptical view of homeopathy" into its own section? Or to rename "The skeptical view of homeopathy" to "The scientific status of homeopathy"? (And moving "Homeopathy not completely harmless" someplace else.) User:Art Carlson 11:47, 2005 Jun 17 (UTC) ::::::we don't write articles from a scientific POV.User:Geni 12:00, 17 Jun 2005 (UTC) :::::::The information on the studies is "scientific" and leads one to be "skeptical" of homeopathy. The question is, which label is more accurate, more informative, or more neutral? I certainly won't press the point. That would be spoiling for a fight. I do plan to throw out the section on "Some specific ..." and move the introductory citation of Renan and Rodrigues to "The skeptical view of homeopathy" if I don't hear any objections soon. User:Art Carlson 12:10, 2005 Jun 17 (UTC) == A possible mechanism == I added this section as a rebuttal to the oft-repeated skeptical position that "there is no possible mechanism for homeopathy". While this is true re. potentization/water memory etc, it is not at all the case re. the Law of Similars. The burgeoning field of "Darwinian medicine" is based on a realization that symptons can sometimes be a "good thing", rather than something to be treated. Isofar as the Law of Similars advocates substances that induce specific symptoms, Darwinian medicine provides a clear mechanism for the Law of Similars. :Your insert states what appears to be your opinion that "there is a plausible (though unproven) potential mechanism". My opinion is to the contrary. The mechanism you describe is not plausible, because of the negligibly small quantities of any active ingredient in a typical homeopathic remedy. :I'm not going to edit your insert by adding my opinion that this theory is absurd. My opinion doesn't matter -- but neither does yours. I'm deleting the whole section. If you want to restore it, provide a citation to some notable spokesperson who says it, and attribute it to that spokesperson rather than stating it as a fact. User:JamesMLane 07:43, 20 Jun 2005 (UTC) :: Did you actually read the section before deleting it? It specifically states that the mechanism is for the Law of Similars, not Potentiatization, so your objection (negligibly small quantities) is entirely baseless. And the section clearly states that it is a *plauible* mechanism, not a proven one. Unless you can provide a good argument as to why this mechanism is unplausible (since it is prima-facia highly plausible), your objection is merely dogmatic. I'm restoring the section; if you want to delete it, say why the mechanism is implausible (and try and avoid using a straw man this time). Since you insist on a "authority", mechanism will be attributed to Dana Ulman, MPH. http://www.homeopathic.com/articles/intro/immune_system.php JColvin, 22 Jun 2005 :::You apparently don't have much experience with Wikipedia. We try to focus on ideas and we Wikipedia:No personal attacks. Given that my comment on this talk page quoted part of the passage verbatim, it was unnecessarily snide of you to ask whether I had read the passage. You can express your disagreement without such inflammatory phrasing. To give the obvious answer to your question, though: Yes, I did read it before deleting it. Let's assume hypothetically that St. Fraudswort herb causes fever. Let's further assume hypothetically that the misnamed "Law of Similars" (actually, the "Wild and Unsubstantiated but Potentially Lucrative Conjecture of Similars") is completely true, and that an appropriate dose of St. Fraudswort will therefore cure a fever. It remains true that this is ''not'' a plausible mechanism by which actual homeopathic "remedies" could work, because the dilutions are so great that most of the patients are not actually receiving any St. Fraudswort, or are receiving a negligibly small amount. You might as well say that a solution of St. Fraudswort, whether diluted or undiluted, will cure headaches, because hokumweed causes headaches and like cures like. The "Law of Similars" can't apply unless, at a minimum, the patient is receiving a substance similar to what causes the symptom. :::Furthermore, it's not my burden to prove that the mechanism is implausible. I'm not saying that the encyclopedia should assert, as a matter of fact, that the purported mechanism is impossible (although it is). Our NPOV policy precludes the flat assertion that it's plausible ''or'' implausible. That's why I "insist on a 'authority'" -- because I follow the policy. We can report an opinion on a disputed subject, provided we make clear that it ''is'' an opinion, and whose. :::For now, I'll recast the subsection in accordance with Wikipedia rules. Longer term, I'm not sure it belongs in the article, whether attributed or not, and even if it's kept it should probably be somewhere else. User:JamesMLane 19:42, 22 Jun 2005 (UTC) ::::If you (JColvin) read the section on "Lack of a mechanism", you know that it refers ''only'' to the Law of Infinitesimals, not to the Law of Similars. It is true that the latter is not as crassly at odds with science as the first. Is there a good reason for including a counter argument to an objection that nobody makes? Or can you cite someone arguing that "there is no possible mechanism for the Law of Similars"? If we want to include more detail on the Law of Similars, then it belongs somewhere else, probably in the section so titled. And then we would have to include a bit about the difficulty of knowing just what the "Law" is supposed to be saying, and about the fact that there are more exceptions than applications of it. I will delete the section again. If you like, you can reinsert it under "The law of similars" and I will edit it there. User:Art Carlson 19:54, 2005 Jun 22 (UTC) :::::Ok, reinserted in section (Law of similars). Please refer to the final sentence of the section on Lack of mechanism; "Even if a homeopathic preparation somehow preserves information from the original substances, there is absolutely no plausible mechanism by which that should effect a cure."; this implies that there is no mechanism for Law of Similars. Similarly, "While proponents may consider the mechanism of homeopathy to be an interesting side issue, skeptics consider the lack of any plausible mechanism to be a serious problem, raising the bar on the quality of evidence required .. ", does not qualify the lack of mechanism to merely the Law of Infinitesimals. If this section indeed relates *only* to the Law of Infinitesimals, then I suggest this final sentence be removed (I also note that this sentence is a flat assertion lacking authority, contra the wiki rule mentioned by James above), and that the relevance of the section be explicated (perhaps by changing the title to "Lack of a mechanism for Law of Infinitesimals), and editing the other sentence quoted above. :::::Since homeopathy skeptics usually claim merely that "there is no mechanism for homeopathy" without explicitly qualifying the objection only to Law of Infinitesimals, I think it is valuable to reference a possible (IMHO plausible), albeit unproven mechanism. :::::Since the new subsection (Possible Mechanism) merely relates to a *potential* mechanism, and notes that the mechanism is hardly foolproof (ie. substance could cause damage), an exhaustive list of exceptions does not seem warranted. :::::Re. (JamesMLane objecion); again, this mechanism applies *only* to law of similars. It has no bearing on debate as to quantity of active ingredient (although I would note that many retail homeopathic remedies are not merely distilled water, but contain varying amounts of active ingredient). JColvin 2005 Jun 22 ::::::active ingredient? botulism A toxin is about the only thing that can have an effect even at the relitavly low potency 6X.User:Geni 02:26, 23 Jun 2005 (UTC) :::::::Not true. 6X corresponds to ppm. Endocrine disruptors, hormone mimics, dioxin etc are active at ppb. http://californiaagriculture.ucop.edu/0204JA/briefs.html ::::::::no since we are dealing with aquious solutions ppm is 1 mg/dm3 . Now if the mother tinctures were at 1 mole (they are unlikely to be anything near that) and the molicules wieghed 100 daltons then we are already down to 0.1 ppm. Now we know that the solubility of this molicules isn't very high (big molicules never are) and the mother tinctures tend to be of a pretty low concentration so if you think you are breaking the PPB mark I sugest you do some more reseach into how homeopathic remedies are in fact made. we will deal with grafting (wich destories your case completely) latter.User:Geni 03:10, 23 Jun 2005 (UTC) :::::::::If you want to argue that most homeopathic remedies are pure distilled water and function on placebo alone, I won't disagree. Just don't throw out the baby (rationale for law of similars) with the distilled water.User:Joncolvin 05:06, 23 Jun 2005 (UTC) ::::::::::Thee "rationale" is not consistant with our knowlage of the immune system and desease.User:Geni 12:19, 23 Jun 2005 (UTC) ==Homeopathy not completely harmless== Zicam regularly contians active ingredents and claims to be homeopathic.User:Geni 11:58, 22 Jun 2005 (UTC) ==Rethinking tone of whole article== I am joining the discussion before introducing any substantial changes. I am a homeopath with an strong interest in philosophy of science. My main concern with the article is that it falls flat on its face by trying to be exegetical and evaluative all at once. Regardless of your individual inclinations for or against homeopathy, the purpose of an encyclopedia entry is to present the subject matter from the perspective of its internal logic. One doesn't, for example, begin an article on Christanity with something like "...is the world's largest religion, notable for its controversial tripartite characterization of God. Moreover, no plausible mechanism for the existence of God has been found." The conrovertiality of homeopathy need not be alluded to until later on (entirely contained within extensive "Skeptical View..." and "Mechanism..." sections) because any semi-intelligent reader will realize along the way that there are 'interesting' features to homeopathy. I would like to request that those interested in the discussion read the following article: http://www.thespiritofhomoeopathy.com/evolution.html which not only provides a superb historical overview of homeopathy (albeit with an over-representation of info on Indian homeopathy, where the article was written), including some recent developments that are controversial even within the homeopathic community, but illustrates how to approach a subject-matter without prejudice, but just describe it for what it is. At the end of the article one isn't compelled to cry out "Wow! Homeopathy is incredible"; rather, one is able to begin evaluating the subject-matter from a position of knowledge. More specifically for our purpose, the arrangement of the article is, I believe, the proper way to arrange the early part of this entry. Only following a similarly comprehensive description should the various complexities be dealt with. Could we discuss the issue I brought up and create a fresh outline before returning to the text? It may require several passes just to arrange the sections correctly. User:Davidnortman 05:55, 23 Jun 2005 (UTC) ::The article you reference has some interesting historical material, though an awful lot of stuff I found uninteresting. More to the point, its POV is thoroughly homeopathic, not in any way a paragon of encyclopedic style. User:Art Carlson 08:44, 2005 Jun 23 (UTC) :I assume you are referring to the overview/preface? I think it is kosher to refer to controversy here; the preface should give a quick summary of the entire article, and controvery is definitely part of the parcel for this subject. The analogy with religion is not entirely fair; homeopathy claims to be a science, Christianity does not. Most people are well aware that religions are controversial; this might not be the case for those new to homeopathy. User:Joncolvin 05:42, 23 Jun 2005 (UTC) There should be a single reference to controversy toward the end of the introduction, alluding to the fact that following the description of homeopathy will be critical analysis. As of now there are two references which immediately divert the reader away from first understanding homeopathy on its own terms toward evaluating it prematurely. (I find that most people that criticize homeopathy know almsot nothing about it, and I presume that the purpose of a critical perspective here is to produce people who are critical of homeopathy once having learned about it.) A proper article consists of exegesis followed by critique, in this order and with clear separation between the two. For example, the use of submolecular dilutions should be in the exegesis, and a criticism of the same in the critical section later on, not immediately following the description so as to interrupt the still-incomplete narrative flow. The overriding concern should be for clear rhetoric (in the classical sense of the term) which permits the reader to make proper judgments. User:Davidnortman 06:06, 23 Jun 2005 (UTC)
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