Talk:Traditional Chinese medicine/Archive 7

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Non-notable or duplicate sources moved to talk

These sources add nothing to the reference section. If a source can be used in the article it should be used in the body of the article after a sentence. QuackGuru (talk) 23:17, 26 December 2013 (UTC)

POV? These are many of the basic textbooks on the subject. These are notable and essential sources. Are you saying they are not used in the article, or are you saying they are not reliable per NPOV? Please explain more what you are doing.Herbxue (talk) 06:40, 27 December 2013 (UTC)
I removed promotional and dated sources that do not belong inside the reference section. There are over 200 sources in the body of the article. You have not explained how these sources are notable or essential. QuackGuru (talk) 07:12, 27 December 2013 (UTC)
Promotional? I guarantee you have read exactly ZERO of these books. The onus is on you to justify undoing other people's good faith work, not on me to block you from removing decent edits. Many of these are basic textbooks that support the descriptive content in this article. Herbxue (talk) 07:23, 27 December 2013 (UTC)
These seem to be a pretty random mixture of scholarly historical works and in-the-field alt. med. stuff. At the very least this needs to go in a separate bibliographical section and be divided up according to type of work. But I also have to wonder about the merits of these works since they are not actually used as references in the article. Mangoe (talk) 15:39, 27 December 2013 (UTC)
I agree. These are not references - that section is automatically populated by inline citations of references used to source specific text in the article. I've removed them. Dougweller (talk) 17:22, 27 December 2013 (UTC)
Did you really check them? Because most of those I checked were actually used as references. And are now missing. --Mallexikon (talk) 05:21, 30 December 2013 (UTC)
Ok, I was under the impression QG was attempting to remove all the article content associated with some of the books in this list, such as Deng and Kaptchuk, which are basic references on the subject. If they are not needed to support the current descriptive text as-is then no problem.Herbxue (talk) 20:07, 27 December 2013 (UTC)

Paul Unschuld is outdated and POV? He's probably the most respected historian of Chinese medicine on the planet. A number of the other books are well-regarded textbooks within the field, and as such at least some belong here; being out of date isn't an issue because they're introductions to a traditional medicine. Agree we can trim the list, but deleting all is a terrible idea. --Middle 8 (talk) 00:09, 30 December 2013 (UTC)

What are you guys doing? Now we have a lot of sources saying something like: "Ross (1984), p. 6" or "Matuk (2006), p. 6". How the hell should the reader find the reference now that you deleted the entire reference list? --Mallexikon (talk) 04:23, 30 December 2013 (UTC)
Yes, the refs for these "short citations" (WP:CITE) should certainly not be deleted. I've restored them and put them under the more appropriate "Bibilography" section [1]. We will want to convert some of these into inline citations or "further reading", and prune some. That will take some time, and painstaking editing. Again, whatever we delete, we have to be sure we're not disrupting short citations. --Middle 8 (talk) 06:37, 30 December 2013 (UTC)
You have not shown what is so important for including numerous sources. The sources are being changed to inline citations where the reader can click on the source to verify the text. Unschuld is already in the body of the article. QuackGuru (talk) 01:33, 31 December 2013 (UTC)
(For the archives, this was cleared up below, under sub-subsection "Inline citations deleted". [2][3]) --Middle 8 (talk) 01:10, 2 January 2014 (UTC)

Inline citations

See reference 6 in Traditional Chinese medicine#History. The reference must be improved with an ISBN number.

Traces of therapeutic activities in China date from the Shang dynasty (14th–11th centuries BCE).<ref name="Unschuld 1985">{{Cite book|last=Unschuld|first=Paul U.|title=Medicine in China: A History of Ideas|year=1985|publisher=University of California Press|location=Berkeley|isbn=978-0-520-05023-5}}</ref>

All the references in the body must be formatted correctly. I made this change for now. QuackGuru (talk) 18:32, 27 December 2013 (UTC)

Since you have already created a proper ref, just fix it. There are lots of references to this source in the article. -- Brangifer (talk) 19:27, 27 December 2013 (UTC)
Usually when I edit this article I get reverted. I am going to discuss first to see if that helps. QuackGuru (talk) 19:43, 27 December 2013 (UTC)
Even non-controversial edits are controversial. Remember what happened at chiropractic. Is it the same editor? QuackGuru (talk) 22:16, 30 December 2013 (UTC)

Reference 8: <ref>{{Cite book|last=Peng|first=Bangjiong 彭邦炯 (ed.)|title=Jiaguwen yixue ziliao: shiwen kaobian yu yanjiu ''甲骨文医学资料: 释文考辨与研究 [Medical data in the oracle bones: translations, philological analysis, and research]''|year=2008|publisher=Renmin weisheng chubanshe|location=Beijing|isbn=978-7-117-09270-8}}</ref> QuackGuru (talk) 19:43, 27 December 2013 (UTC)

QG the reason you get reverted so often is you edit at a frenetic pace - no working professional in the real world could possibly keep up with you, and so we are naturally suspicious. Nobody has edited at a rate close to yours since the infamous PPdd, who was banned from this article. Frankly, I am not yet convinced that you are not the same editor as PPdd. Maybe if I won the lottery and started smoking meth I could keep up with you, but until then I will be hyper critical of your edits. Herbxue (talk) 08:38, 28 December 2013 (UTC)
So, you appear to be saying you revert QG a lot not because his edits are not properly sourced or inaccurate, but because he works too fast. Is there a WP:GUIDELINE for that? --Roxy the dog (resonate) 09:36, 28 December 2013 (UTC)
There is one that I'm aware of having to do with seeking agreement before making major changes, and that would be WP:CONSENSUS. --Middle 8 (talk) 08:51, 31 December 2013 (UTC)
I am saying that IMO QG makes edits that seem rash and overly bold, and that he sometimes seems to be on a mission to remove sourced material, in order to push a POV. Any revert I've done has been a good faith effort to preserve someone else's good work or to preserve good sources. Herbxue (talk) 09:35, 29 December 2013 (UTC)
In that case perhaps you should strike the bit where you say "QG the reason you get reverted so often is you edit at a frenetic pace - no working professional in the real world could possibly keep up with you, and so we are naturally suspicious." and the bit where you accuse him of being a sockpuppet, which would be the following ... "Nobody has edited at a rate close to yours since the infamous PPdd, who was banned from this article. Frankly, I am not yet convinced that you are not the same editor as PPdd." and the bit where you again accuse him of not editing properly because he works too fast and you would need illegal drugs to keep up with him, which is this bit ... "Maybe if I won the lottery and started smoking meth I could keep up with you, but until then I will be hyper critical of your edits."
Perhaps you should strike it all. --Roxy the dog (resonate) 10:44, 29 December 2013 (UTC)

I think QG can speak for himself, my guess is he is less offended than you think, perhaps even a little amused. Herbxue (talk) 17:26, 29 December 2013 (UTC)

Inline citations deleted

Some of the inline reference citations were deleted from the article and numerous references were dumped into the article gain. We do not need numerous references. The inline citations are enough. There is no need to have duplicate references in another section or numerous references. QuackGuru (talk) 20:31, 30 December 2013 (UTC)

Thank you for converting short references (Smith, 19xx, p.x) to inline; I'm going to restore those changes now. I think you were reverted because you kept deleting the references -- which is a major change -- without consensus, and you didn't propose a way forward that editors could agree upon. If you'd say "I propose removing these, as long as we make sure that we convert them to inline citations where necessary", I don't think there would be much objection. But when you call them "outdated and POV sources", when many/most are not, sure there will be pushback.
Some changes are so bold that it's better to first propose them without going through a WP:BRD cycle, but even if you are going to go that way, we all need to understand each other. I now see what you mean when you said "All the references in the body must be formatted correctly. I made this change for now." But it wasn't clear at the time.
Please, let's mutually AGF and make sure everyone knows everyone else's intentions, and propose major changes here first, just as is done on any article prone to controversy. This article is going to degenerate if we don't slow down, AGF and really listen to each other. I can already see the "sides" lining up and it's unnecessary. Let's avoid drama. --Middle 8 (talk) 08:06, 31 December 2013 (UTC)

Update: OK, I restored the inline citations, mainly by reverting back to QG's previous version. (Also restored the "drug discovery" section, mentioned elsewhere.) Diff from most recent edit by A1Candidate; Diff from most recent QG edit. QuackGuru had, in fact, diligently converted a bunch of short citations to inline. A1Candidate had reverted, understandably, because this fact wasn't clear. And I let QG's removal of the sources at the bottom stand, since a lot (most?) of them are now in the inline citations. Still, it's good that we have the list above, since we may end up using a few at some point. For instance, I'd like a good textbook in the ref section. Anyway, let's slow down a little and talk things over more. --Middle 8 (talk) 16:19, 31 December 2013 (UTC)

The one thing that got lost in the transition from short citations to inline citations is page numbers, FWIW. Anyone know an easy way of using different page numbers for the same inline ref? thanks, --Middle 8 (talk) 05:37, 1 January 2014 (UTC)
TEMPLATE:RP ? Alexbrn talk|contribs|COI 06:09, 1 January 2014 (UTC)
That's the one, thanks! Along these lines, I'm trying to remember a template I've seen for adding a quote without adding it to an inline citation. I think it's similar to the one you mentioned, maybe Template:Note. Ring any bells? Happy ringing in the New Year bells from my time zone, btw. --Middle 8 (talk) 06:34, 1 January 2014 (UTC)

WP:MEDRS violations again

I deleted the MEDRS violation. We have a recent 2013 review for the antimalarial herb artemisia annua. QuackGuru (talk) 02:24, 22 December 2013 (UTC)

The source given was a primary source (by the scientist who discovered artmisinin), so of course you're right... But I'd like to point out that the information was obviously correct (a simple query of the wikilinks substantiated it), and could be easily MEDRS'd (as I did now). So why did you delete it anyway? Trying to delete anything positive about TCM if you can, even when it's true? --Mallexikon (talk) 07:36, 22 December 2013 (UTC)
You did not MEDRS the sources. You added dated sources. I replaced it with better sources. QuackGuru (talk) 19:38, 22 December 2013 (UTC)
You continue to (intentionally?) misunderstand WP:MEDDATE... if you have a newer and better source - great. But don't delete RS material without discussion. For some material, there are no newer sources or there don't have to be newer source (just read WP:MEDDATE again, will ya?). --Mallexikon (talk) 06:45, 23 December 2013 (UTC)
I re-instated the sourced material you deleted, but I kept your newer (and better) efficacy sources. Please note that artemisinin and huperzine A do not constitute regular CHM. Thus, they need a little more context. --Mallexikon (talk) 07:01, 23 December 2013 (UTC)
You should not restore MEDRS violations. For example, the 2003 source is too old. QuackGuru (talk) 03:47, 24 December 2013 (UTC)
"Efficiency has been documented in the case of artemisinin, a malaria medication which is extracted from Artemisia annua[187][original research?][unreliable medical source?],"
"The insistence that artemisinin derivatives must be used in combination therapy (Figure 1) may protect it from resistance, at least for some time. This will require careful evaluation of the efficacy of the added drug to protect artemisinin. The one hope is that the use of artemisinin combination therapy will remain effective and that mortality associated with a change in drugs will be prevented."[4]
The current text is original search. It does not summarise the source. The other problem is it is a cherry picked primary source. QuackGuru (talk) 04:16, 24 December 2013 (UTC)
1.) The facts that artemisinin is an important malaria medication extracted from Artemisisa annua will not change, thus, WP:MEDDATE does not apply. Both of these facts are mentioned in the source. Please explain why you think this original research.
2.) On what ground grounds do you challenge this source to not be reliable? This kind of tagging you indulge in has to be well founded, you know? Otherwise it'd be a case of WP:Tag bombing, which is punishable by a block. --Mallexikon (talk) 05:36, 25 December 2013 (UTC)
I previously explained the text is original research and the sources are old or unreliable. You have not provided verification because the text it is original research.
Efficiency has been documented in the case of artemisinin, a malaria medication which is extracted from Artemisia annua[187][original research?][unreliable medical source?], a traditional Chinese herb of the "heat-clearing" category.[188][unreliable medical source?] A 2012 review found that artemisinin-based remedies are the most effective drugs for the treatment of malaria.[189]
Another example of CHM that has attracted the interest of medical science is huperzine A, which is extracted from Huperzia serrata.[190][unreliable medical source?] However,[original research?] a 2013 systematic review and meta-analysis found only[original research?] poor quality evidence that huperzine A seems to improve cognitive function and daily living activity for Alzheimer's disease.[191]
"The facts that artemisinin is an important malaria medication extracted from Artemisisa annua will not change" is not what the source says. The reference 187 is older and you have not shown it is a review. There is a newer a 2013 systematic review on the topic. The reference 187 obviously violated MEDRS.
The reference 188 is from the Institute for Traditional Medicine, Portland, Oregon. It is not a review and it is not about efficacy. The reference 188 obviously violated MEDRS.
The reference 190 is from 2003. The reference 190 obviously violated MEDRS. A 10 year old reference is way to old when you know there are newer sources on the topic.
The 187 reference says:"These studies were the first to suggest that combination therapy should be considered to prevent recurrence and development of resistance (Jiang et al., 1982 and Li et al., 1984)."[5]
The 187 reference also says:"The insistence that artemisinin derivatives must be used in combination therapy (Figure 1) may protect it from resistance, at least for some time. This will require careful evaluation of the efficacy of the added drug to protect artemisinin. The one hope is that the use of artemisinin combination therapy will remain effective and that mortality associated with a change in drugs will be prevented."[6]
"Efficiency has been documented in the case of artemisinin," is original research. The source did not say it has efficiency alone. Again, the source said: "the hope is that the use of artemisinin combination therapy will remain effective."[7]
The current text using the 187 reference is original research because the source did not say what is currently in the article. You do not have WP:CON for the recently added original research and disputed sources. QuackGuru (talk) 22:19, 25 December 2013 (UTC)

1.) "Efficiency has been documented in the case of artemisinin, a malaria medication which is extracted from Artemisia annua" is knowledge/information that will not change anymore. Thus, WP:MEDDATE does not apply. The source given here is a secondary source from a respected scientific journal. It is noted in the article that artemisinin is effective in treating malaria ("...the paper describing artemisinin's X-ray crystal structure, pharmacology, and efficacy against nonsevere and severe cerebral malaria..."). This is perfectly compliant with MEDRS.,/br> 2.) "... a traditional Chinese herb of the "heat-clearing" category" is also knowledge/information that doesn't change any more. This is the traditional view of TCM. The source given is reliable for TCM content.
3.) "Another example of CHM that has attracted the interest of medical science is huperzine A, which is extracted from Huperzia serrata" is, again, knowledge/information that does not change anymore. Thus, WP:MEDDATE does not apply.
I think I've been very patient in pointing this out to you twice now. If you insist on tagging this even though you've been explained repeatedly that and why there's no problem, I'll push for some kind of third-party review of this article. As I've emphasized before, disruptive tagging is punishable by a block. --Mallexikon (talk) 05:31, 26 December 2013 (UTC)

Artemisinin is an effective antimalarial but drug production requires an expensive industrial isolation and purification process; so what is the relevance to "traditional Chinese medicine"? The whole plant is not an effective antimalarial. Alexbrn talk|contribs|COI 08:33, 26 December 2013 (UTC)

Extracts of traditionally used medicinal plants, minerals, or animals are generally considered to be part of contemporary TCM, especially in Asia. Popular examples include "Huang Lian Su" (extracted berberine from coptis used as an antibiotic) and "Kang Lai Te" (extract of yiyiren / job's tear used as a chemotherapeutic agent) - the modern use of the isolate is similar/the same/ or related to the traditional use of the whole medicinal/herb.Herbxue (talk) 08:58, 26 December 2013 (UTC)
"is similar/the same/ or related to the traditional use" ← for Artemisinin, your source? Alexbrn talk|contribs|COI 09:04, 26 December 2013 (UTC)
(Add) In this source it states that it was only by moving away from the "traditional" methods and adopting a method of ethanol-based extraction that an effective drug was found. This source was being used without mentioning this (naughty!) Alexbrn talk|contribs|COI 09:10, 26 December 2013 (UTC)
The source says "After reading the ancient Chinese medical description, “take one bunch of Qinghao, soak in two sheng (∼0.4 liters) of water, wring it out to obtain the juice and ingest it in its entirety” in The Handbook of Prescriptions for Emergency Treatments by Ge Hong (283–343 CE) during the Jin Dynasty, she realized that traditional methods of boiling and high-temperature extraction could damage the active ingredient. Indeed, a much better extract was obtained after switching from ethanol to ether extraction at lower temperature." I re-instated the material. --Mallexikon (talk) 09:21, 26 December 2013 (UTC)
For similarities between the TCM use of Qing Hao for fevers categorized in the same way as malaria, see traditional formulas "Hao Qin Qing Dan Tang" and "Qing Hao Bie Jia Tang", for context, see: http://94.23.146.173/ficheros/337d241415a79b1c4b2a8cad4b9d886d.pdf; http://www.yorkspark.co.uk/?p=332; http://www.ncbi.nlm.nih.gov/pubmed/22033738; http://link.springer.com/chapter/10.1007%2F978-3-540-79116-4_11. These are not meant to prove to you that the use of artiminsin grows from a traditional viewpoint only, it is to show you that TCM considers such extracts to be part of its evolving materia medica, and many of the researchers delivering these extracts are doctors trained in both TCM and biomedicine (as we all are now).Herbxue (talk) 09:27, 26 December 2013 (UTC)
"grows from a traditional viewpoint" ← I can go with that (and have done so with the new "Drug discoveries" section). But including this material in a way that implies that artiminsin tells us anything about the "efficacy" of "herbal medicine" in TCM (itself) is very bad, without RS explicitly backing that. Alexbrn talk|contribs|COI 09:38, 26 December 2013 (UTC)
"Very bad"? What does that mean? You seem to miss my point. "TCM" is a term coined in the 1950's and is inclusive of Han dynasty theories and practices as well as contemporary theories and practices. The word "藥" which we translate as "herb" or "herbal medicine" for convenience actually means "drug" or "medicinal". TCM considers artiminsin, berberine, ginsenoside, etc. to be treatments that are part of TCM, both developed by and used by TCM practitioners. If you want to say that they say nothing about the formative theory of TCM developed in the Warring States to Han dynasty, that would obviously be accurate, but don't confuse the "Traditional" in TCM as being synonymous with "ancient".Herbxue (talk) 10:31, 26 December 2013 (UTC)

Mallexikon - I had re-added the material (properly represented, in a new section) already, so you duplicated it. By putting this in the "Herbal medicine" section you are misrepresenting what is being discussed, as well as misrepresenting the source. Alexbrn talk|contribs|COI 09:31, 26 December 2013 (UTC)

Ouch, sorry! Didn't realize I duplicated it. New section actually makes sense. --Mallexikon (talk) 09:48, 26 December 2013 (UTC)
Mallexikon You recent changes have duplicated material in the detail article and contradicted it, giving out-of-date/false health information about the drug's current effectiveness. There's also some OR/SYN going on by mentioning this "heart-clearing" stuff in this context. Alexbrn talk|contribs|COI 10:42, 26 December 2013 (UTC)
The text failed verification and the sources were not MEDRS complaint. Mallexikon did not provide verification for the original research and did not show the sources were MEDRS complaint but decided to removed the tags when the sources and text had problems. Before restoring disputed text and sources there must be consensus first. I moved the sourced text that is not about efficacy to other articles.[8][9] QuackGuru (talk) 23:08, 26 December 2013 (UTC)
You seem to misunderstand something here... if you want to delete reliably sourced text, you need consensus for that. And why is the "Drug discoveries" section that Alexbrn created not there anymore? --Mallexikon (talk) 04:36, 30 December 2013 (UTC)
You have to gain consensus to restore the newly added text. I moved the text about the "Drug discoveries" to the other articles. QuackGuru (talk) 19:06, 30 December 2013 (UTC)

The continued problems with the text and new section were explained here. Since editors are unable to work out the problems here I posted a comment at a noticeboard. QuackGuru (talk) 18:42, 31 December 2013 (UTC)

@QG, we should be able work stuff out here; it takes patience and compromise, and some AGF (e.g., being open to the idea that if I'm the only one who thinks there's a problem and others are asking me to move on, I should probably move on). Comments:
  • OR: I don't see OR happening here; I do see you repeating the charge, but don't see why. Can you explain or provide a diff for your reasoning?
  • The Cell source is indeed secondary, being a history of artemesinin. You keep insisting it's primary, which reminds me of when you kept insisting at Talk:Acu that a particular meta-analysis had to be primary because the authors referred to it as a "study" and it reported "findings".
  • MEDDATE makes exceptions in this case as Mallexikon already pointed out, yet you just keep repeating the "MEDRS violation" mantra. We went through a variation on this at Talk:Acu as well, which wasted more time. That gets frustrating for all of us.
thanks, and Happy New Year from my time zone, --Middle 8 (talk) 07:42, 1 January 2014 (UTC)
For starters, the "heart-clearing" stuff is SYN. I removed the SYN. Scientists are moving away from traditional methods. The drug is not a traditional Chinese herb of the "heat-clearing" category.
Read this previous comment: "Mallexikon You recent changes have duplicated material in the detail article and contradicted it, giving out-of-date/false health information about the drug's current effectiveness. There's also some OR/SYN going on by mentioning this "heart-clearing" stuff in this context. Alexbrn talk|contribs|COI 10:42, 26 December 2013 (UTC)"
"After reading the ancient Chinese medical description, “take one bunch of Qinghao, soak in two sheng (∼0.4 liters) of water, wring it out to obtain the juice and ingest it in its entirety” in The Handbook of Prescriptions for Emergency Treatments by Ge Hong (283–343 CE) during the Jin Dynasty, she realized that traditional methods of boiling and high-temperature extraction could damage the active ingredient. Indeed, a much better extract was obtained after switching from ethanol to ether extraction at lower temperature."[10]
I replaced non-neutral text with text that is closer to the source. QuackGuru (talk) 03:32, 2 January 2014 (UTC)

although…although…

There's a horrendously complex sentence with two "although"s in the History section. It's not entirely clear what each "although" clause is supposed to be modifying. Any chance of a split into two sentences?:

This formulary was also the earliest public Chinese medical text to group symptoms into clinically useful "patterns" (zheng 證) that could serve as targets for therapy although the private scrolls held by families were jealously guarded and although it is not known for sure what is in them, the traditional school today say that they have had this information for much longer. --Ricklaman (talk) 03:29, 3 January 2014 (UTC)

Drug discoveries

I reinstated this section, because you can't lump artemisinin and huperzine A with traditional herbs... they're evolved from that and not used in a traditional way. I've explained in details why the sources used here are either MEDRS or don't fall into that category (e.g., when claiming that A. annua is a herb from the "heat clearing" category. That's a TCM term and doesn't have to backed up by MEDRS, just by a reliable TCM source). --Mallexikon (talk) 05:19, 30 December 2013 (UTC)

@QuackGuru: You deleted this section again without discussion or consensus. Please refrain from deleting reliably sourced material this way. Thanks. --Mallexikon (talk) 01:26, 31 December 2013 (UTC)
I did discuss it. QuackGuru (talk) 01:35, 31 December 2013 (UTC)
No you didn't. This diff you presented just shows how you clearly didn't listen to what I explained. --Mallexikon (talk) 05:05, 31 December 2013 (UTC)
I restored it. It appears well-sourced, and likewise appears that more editors here want it than not. --Middle 8 (talk) 16:09, 31 December 2013 (UTC)
There is a SYN violation. See Talk:Traditional Chinese medicine#WP:MEDRS violations again. QuackGuru (talk) 01:15, 2 January 2014 (UTC)
See Revision as of 10:42, 26 December 2013. This was explained a little while ago that there are problems with the text. Please move on. QuackGuru (talk) 03:38, 2 January 2014 (UTC)

The "OR/SYN" that you and Alexbrn object to is, essentially, this:

  • No SYN: "They discovered a compound that is extracted from Artemisia annua, a Chinese herb. (Ref A)"
  • Supposedly SYN: "They discovered a compound that is extracted from Artemisia annua, a Chinese herb (Ref A) of the Heat-Clearing variety. (Ref B)"

Which is exactly like saying:

  • No SYN: "They discovered a compound on Mars, a planet. (Ref A)"
  • Supposedly SYN: "They discovered a compound on Mars, a planet (Ref A) that is fourth from the Sun. (Ref B)"

This isn't synthesis; it's definition. In SYN, a third, novel idea is inferred from two different sources. Since that's not going on here, and both references are reliable, I think a revert of your deletion is justified. --Middle 8 (talk) 05:00, 2 January 2014 (UTC)

Scientists are moving away from traditional methods. The drug is not a traditional Chinese herb of the "heat-clearing" category. Where does the sources say a Chinese herb of the Heat-Clearing is a drug? Your using a separate source an the end of the section. In that context it is SYN. QuackGuru (talk) 05:08, 2 January 2014 (UTC)
I wrote the text according to the source and now the neutrally written text was deleted. I thought editors wanted to keep the text. The main point of the source was deleted. QuackGuru (talk) 05:20, 2 January 2014 (UTC)
I'm not talking about extraction above. Although, since you mention it, the source says that the traditional method for this herb is at room-temperature, an exception to the usual method of boiling. The scientist recognized this exception, and decided colder was better. So, the scientist modified the method -- who gives a shit whether toward or away from the traditional method, except those who want to push the POV that the traditional method rules/sux? That's why I removed it altogether [11]; it's peripheral, and a dumb micro-edit-war magnet. Sheesh! Your version is even more of a POV-push than the "inspired" wording; at least that version (the earlier one in this diff) accurately implied that the traditional method was cold (i.e. room-temperature, which pre-refrigeration meant "cold", as compared to boiling).
As far as the "heat-clearing" business, both the source about drug isolation and the source adding the "heat-clearing" definition say it's a traditional Chinese herb. So, per my e.g.: "two sources agree Mars is a planet; the second adds it's fourth from the Sun." Mentioning both facts, without making a new inference, is not OR/SYN. I'd guess that Alexbrn didn't realize both sources said the plant in question is a TCM herb, hence his concern about SYN. My edit (version; diff)puts refs by the exact statements they make, removing the uncertainty. --Middle 8 (talk) 07:45, 2 January 2014 (UTC)

It's the whole "Aha! 'heat-clearing'! see how the ancient wisdom of fever-prevention shines through in modern fever-fighting medicine; take that skeptics!" implication that is the problem here. Alexbrn talk|contribs|COI 08:18, 2 January 2014 (UTC)

Yes, I see the potential problem when information is included selectively. Put in all the dots and the implication goes away. AFAIK, the relevant information for any herb includes "temperature, flavor and channels". (This is so just as surely as astrologers talk about X, Y and Z properties of houses, signs and planets. Typical symbolic-correspondence thinking.) Putting in the additional TCM-y info for Artemisia and the other herbs makes a more TCM-ishly complete article, and removes the (semantically accidental) implication you're concerned about. (BTW, "Heat-Clearing" is a term of art, and not all Heat-Clearing herbs are used for "infection-like" TCM patterns, or vice-versa.) --Middle 8 (talk) 10:11, 2 January 2014 (UTC)
Simple then: does RS link "heat-clearing" to artemisinin, or is it you? Alexbrn talk|contribs|COI 10:21, 2 January 2014 (UTC)
Huh? Nobody ascribes "heat clearing" to artemesinin. It's the herb that has the TCM properties. I was about to redo the section as below (hidden) but your edit came in first, and it looks fine. 2007's a bit old for a source saying little or nothing's come of the field, isn't it? --Middle 8 (talk) 12:14, 2 January 2014 (UTC)
It would be if there were reasons to doubt it still applied. Are there more recent "success stories" ? Alexbrn talk|contribs|COI 12:34, 2 January 2014 (UTC)
No idea. I think the source is good and you summarize it well; I'm just not sure it passes muster age-wise. But let's go ahead and leave it and see if it sticks. Middle 8 (talk) 16:15, 3 January 2014 (UTC)
Perhaps a too-unwieldy way incorporate TCM herb properties into drug section

Another way to incorporate TCM properties of herbs

Below is my original idea for drug research section, although what we currently have from Alexbrn is fine. Still might be used someplace. Maybe we already have something tabular in some article; I'm not much of an herb guy and haven't checked it out. --Middle 8 (talk) 12:14, 2 January 2014 (UTC)

  • Artemisia annua (TCM: Qing Hao, taste: markedly bitter in taste; temperature or nature: cold; function: clears heat).[1] Artemisinin was isolated from this herb in the course of research to develop antimalarial drugs.[2] A 2012 review found that artemisinin-based remedies are the most effective drugs for the treatment of malaria.[3]
  • Huperzia serrata (TCM: Qian Ceng Ta/Jin Bu Huan; Taste: Bitter, Pungent, Slightly Sweet; temperature or nature: neutral; functions: activates blood; eliminates stasis; drains dampness; clears heat).[citation needed] Huperzine A is extracted from this herb, and is of interest due to its alleged neuroprotective properties.[4] Despite earlier promising results,[5] a 2013 systematic review and meta-analysis found poor quality evidence that huperzine A seems to improve cognitive function and daily living activity for Alzheimer's disease.[6]

References

  1. ^ Dharmandanda, S. "CHING-HAO and the Artemisias Used in Chinese Medicine". Institute for traditional medicine.
  2. ^ Miller, L.H.; Su, X. (2011). "Artemisinin: Discovery from the Chinese Herbal Garden" (PDF). Cell. 146: 855–58.
  3. ^ Fairhurst, R. M.; Nayyar, G. M. L.; Breman, J. G.; Hallett, R.; Vennerstrom, J. L.; Duong, S.; Ringwald, P.; Wellems, T. E.; Plowe, C. V.; Dondorp, A. M. (2012). "Artemisinin-Resistant Malaria: Research Challenges, Opportunities, and Public Health Implications". American Journal of Tropical Medicine and Hygiene. 87 (2): 231–241. doi:10.4269/ajtmh.2012.12-0025. PMC 3414557. PMID 22855752.
  4. ^ Zangara, A (2003). "The psychopharmacology of huperzine A: an alkaloid with cognitive enhancing and neuroprotective properties of interest in the treatment of Alzheimer's disease". Pharmacol Biochem Behav. 75 (3): 675–86. doi:10.1016/S0091-3057(03)00111-4. PMID 12895686.
  5. ^ Wang, B.S.; et al. "Efficacy and safety of natural acetylcholinesterase inhibitor huperzine A in the treatment of Alzheimer's disease: an updated meta-analysis". Journal of neural transmission. 116 (4): 457–65. PMID 19221692. {{cite journal}}: Explicit use of et al. in: |author= (help)
  6. ^ Yang, G; Wang, Y; Tian, J; Liu, JP (2013). Scherer, Roberta W (ed.). "Huperzine a for Alzheimer's disease: A systematic review and meta-analysis of randomized clinical trials". PloS one. 8 (9): e74916. doi:10.1371/journal.pone.0074916. PMC 3781107. PMID 24086396.{{cite journal}}: CS1 maint: unflagged free DOI (link)

Traditional Chinese medicine minerals

Arsenic
Asbestos
Lead[12][13]
Mercury
Cinnabar
Calomel

Comments? QuackGuru (talk) 03:52, 31 December 2013 (UTC)

What do you propose? I am aware that heavy-metal contamination is a risk with some prepared Chinese medicines, and we should certainly mention this. We should weight the issue properly; the use of certain "traditional minerals" and other toxic chemicals (e.g. aristolochic acid)is intentionally avoided by more responsible manufacturers. --Middle 8 (talk) 08:48, 31 December 2013 (UTC)
I propose summarising the refs. I do not have a specific proposal. For aristolochic acid, do you have a source. QuackGuru (talk) 18:33, 31 December 2013 (UTC)
I would say this better belongs in the herbal medicine article - we've discussed having lists of substances and their characteristics and it is problematic because you can be percieved as cherry picking only the dangerous ones or only the most helpful ones, so the only solution is to be all-inclusive, which is unwieldy. Herbxue (talk) 20:08, 4 January 2014 (UTC)

Two kinds of xue?

In the Qi section (in the bit about ying-qi), there's a reference to "xue" with a 4th tone and no Chinese character. This comes shortly before the section on Xue with a 3rd tone and the Chinese character provided. If these are indeed two different concepts, it would be nice if the writer or a similarly knowledgeable person could explain the 4th-tone "xue" and add a Chinese character where it is first mentioned. If, on the other hand, this is just a tone typo, perhaps he/she/they could correct it? Ricklaman (talk) 03:05, 3 January 2014 (UTC)

Thanks I'll take a look in case someone hasn't already clarified it. Could be 血 vs. 穴 Herbxue (talk) 20:10, 4 January 2014 (UTC)
Blood 血 is 4th tone as a single word and switches when pronounced in front of another word. I switched the single word instance from 3rd to 4th.Herbxue (talk) 21:01, 4 January 2014 (UTC)
Thank you! Great we have someone literate in medical Chinese. --Middle 8 (talk) 01:50, 6 January 2014 (UTC)

Criticism

I note that there is no criticism section. I respectfully suggest that there should be. TCM is based on unscientific and plainly wrong theories, and most of the remedies do not work. Many also involve the death of rare animals. TCM is the only pre-scientific medicine or science which is still being actively promoted. Should not its failings and adverse implications be at least noted?119.224.91.84 (talk) 18:30, 14 November 2013 (UTC)

http://www.ncbi.nlm.nih.gov/pubmed/?term=chinese+herbal+medicine+review
You can help improve the article. The link shows there are many adverse implications. The adverse implications may be noted but no editor at this time is interested in writing about it. QuackGuru (talk) 18:58, 14 November 2013 (UTC)
Criticism is included throughout the article. You have to put things in proper perspective however - this is an encyclopedia and an important goal is to describe the subject, persuading the reader to share your opinion about it would not be as important a goal. Concerning the animal products, you have to separate cultural quirks from the way professionals practice TCM. Rich guys in China do want to eat tiger penises and shark fins, but doctors in TCM hospitals are not prescribing those substances (including bear bile). So before you include sensationalist material, make sure you understand it in proper context.Herbxue (talk) 02:07, 15 November 2013 (UTC)
I definetely think TCM's failings should be included. If you work on this, you could maybe use some of the material that is in the Chinese herbology article as a starting point. --Mallexikon (talk) 04:28, 16 November 2013 (UTC)

Herbxue disagrees with including the studies so I am blocked from improving this article. I have no consensus. Proposal: "The research on the benefit and safety of Chinese herbal medicine for idiopathic sudden sensorineural hearing loss is of poor quality and cannot be relied upon to support their use.[14]" QuackGuru (talk) 20:02, 16 November 2013 (UTC)

Idiopathic sensorineural hearing loss... This seems kind of irrelevant to me. Isn't there maybe a more generalized statement (e.g., no quality research to support the use of TCM herbs in pain syndromes or diabetes or cancer or some else notable disease)? --Mallexikon (talk) 02:41, 18 November 2013 (UTC)
The article is "Chinese herbal medicine for idiopathic sudden sensorineural hearing loss: a systematic review of randomised clinical trials."
This is relevant too because it is about Chinese herbal medicine. You can also add more generalized statements too. QuackGuru (talk) 03:50, 18 November 2013 (UTC)
Proposal: "There is low quality evidence that suggests Chinese herbal medicine improves the symptoms of Sjogren's syndrome.[15]" QuackGuru (talk) 04:05, 18 November 2013 (UTC)
Proposal: "A 2013 Cochrane review found inconclusive evidence that Chinese herbal medicine reduces the severity of eczema.[16]" QuackGuru (talk) 04:19, 18 November 2013 (UTC)
Proposal:"A high percentage of relevant studies on Chinese herbal medicine are in Chinese databases. Fifty percent of systematic reviews in Chinese herbal medicine did not search Chinese databases, which could lead to a bias in the results.[17]" QuackGuru (talk) 04:32, 18 November 2013 (UTC)
Our text as it is states: "Regarding Traditional Chinese herbal therapy, only a few trials of adequate methodology exist and its effectiveness therefore remains poorly documented." In light of this, I would recommend against repeating the same statement in the special case of Sjogren's syndrome or hearing loss. "Fifty percent of systematic reviews in Chinese herbal medicine did not search Chinese databases, which could lead to a bias in the results" might be worth including, however, we might have to back it up with some material regarding the low quality of Chinese studies in general. Otherwise, it sounds like there might be better evidence if only the Chinese studies were included (and I doubt that). --Mallexikon (talk) 05:55, 18 November 2013 (UTC)
The statement about Sjogren's syndrome or hearing loss is specific. This is not repetitive. QuackGuru (talk) 06:48, 18 November 2013 (UTC)

I agree that criticism here is required.

However I see the required criticism in a different light.

Quite often people will choose Chinese medicine when clearly the proper and even indeed more cost effective method lies in the western method. One clear example is a serious bacterial infection. Using herbs the solution could take weeks sometimes months to fully resolve costing several hundreds of dollars U.S. for resolution. The Treatment in western medicine would be relative antibiotics which could take less than a week to resolve and simple antibiotics are very cheap these days ranging from $10-$20 U.S. or less sometimes.

Of course if you change countries and apply this in China, or India, Sri Lanka, or Nepal, your result will be different as the western medicine tends to be more expensive and herbal treatment much less expensive so you the test would have to take into account all countries and cost effectiveness in each country.

Also if you consider the fact that treatment with antibiotics can often lead to weak digestion, See the sources in this article: [1] then you also need to take into account possible follow up treatments required.

Regarding this comment:

TCM is the only pre-scientific medicine or science which is still being actively promoted. Should not its failings and adverse implications be at least noted?

This is simply not true the following different types of "pre-scientific" medicine as you call them otherwise known as traditional medicines that are promoted around the world, this is by no means an exhaustive list only enough to prove my point.

Aryuvedic Medicine. [2]

Mayan Medicine [3]

Sri Lankan medicine. [4]

Tibetan Medicine. [5]

Regarding this comment :

TCM is based on unscientific and plainly wrong theories This is not true.

Which theories can you prove are wrong?

Meridian theory?

Not true it has been physically discovered recently.

Here's what I have: Acupuncture meridian evidence: [6] [7]

Herbal Evidence: The following site is a herbal dictionary site that scientifically explains the herbal effects and quotes sources for studies: If this is not enough or does not contain what you see as facts then let me know and I will provide more. [8]

Please state one theory you believe is wrong and I will provide evidence as to why it is not wrong, but rather only perceived by some to be wrong as they don't understand what is being said. For example some think the spleen does not govern the digestive system so that is wrong. But actually Chinese medicine sees the spleen as part of the thymus and pancreas system as a whole, the world spleen is used only as a place holder as there is no other word for it.

It is difficult to prove Chinese medicine using the double blind test that we use for western medicine, which seems to be the only method that any scientist will accept.

There are two factors at play here that make this true.

1.) We use a western diagnoses of a disease before beginning the treatment. 2.) We apply the same treatment to all patients.

While this seems like a sane thing to do in theory and would prove something indeed works, there are some facts that make this totally useless test.

I'll explain with an example, that may be easy to understand from a western perspective.

If you take five people all having high blood pressure and you want to treat them with the same herbs, or acupuncture points or whatever your method in Chinese medicine you choose is to be the same.

All five of these patients could easily see no improvement.

The reason is all five of these patients could have totally different reasons for high blood pressure. As you may know in western medicine there are two main categories of high blood pressure, Primary and Secondary.

While it is said that Primary has no known cause in Western medicine (Although there are some speculations and even indications in some cases) in Chinese medicine Diagnoses there could be a known different cause for each of the five cases. There are at least five different sources for hypertension from a TCM perspective, and many different treatments for each of the cases.

Also if the person happens to have another health issue the patient also needs to be treated differently at times to avoid affecting the secondary issue causing the treatment to fail, which can happen very easily. One example is digestive weakness, if the herbs cannot be tolerated by the body then the herbs may not have proper effect and cannot resolve the issue, which doesn't mean TCM is ineffective only that the treatment would need to be adjusted to resolve the digestive weakness first, or herbs need to be added to protect the digestion.

The only way to test Chinese medicine effectively would be to take a team of ten doctors or more and get them all to agree on one herbal formula or treatment for each patient separately. These doctors would have to be from the same school of medicine, as there are a multitude of ways to treat ailments even within one methodology such as herbology. A doctor from Southwest china may for example use local herbs from Yunnan province over herbs from another province as they may be known to be more effective that standard TCM herbal selections and in fact depending on how they were taught may not even be aware of the standard herb used for a similar purpose.

The only conceivable way of doing a double blind test is to get an additional five people who have no concept of chinese medicine who also have a mixed variety of hypertension and then feed them all a liquid with a herbal taste to it but without any effect and make sure they don't have access to do research during the trial or they might figure out that their flavour of herbs were wrong for their condition. You would of course still get the doctors to diagnose them and provide a formula that would be applied so that both the doctors and the patients were unaware of which people were getting the herbs.

The numbers stated above of five and five people is only an example and of course would have to be multiplied quite substantially for real clinic trials, but I think my example is clear.


Considering all of this no one has come up with a method to test TCM that will satisfy the scientific community as well as the TCM community as all the scientific tests have not taken all of the above issues into light.

To my knowledge there are no known publications about such tests done in this way, so my citation for this is simply that there are no publications using the above described method, if someone can find an article with the above method used or something similar I will remove my statement.

I use one citation for all of the rest of the above information: [9]

I also add this one point, that I really feel is the most important point. Whether we add criticism or not to this article, I ask one question.

If not traditional medicine, then what do we use to cure illness? What alternative to "nothing" can you provide?

If we disallow alternative medicine, then we simply have no hope to cure degenerative and chronic illnesses.

We simply have know known cures for so many thousands of diseases that we have identified using the scientific method. Western medicine can basically do three things, 1.) Perform surgeries to remove problems and heal wounds. 2.) Clear infections with antibiotics. 3.) Apply control substances to prolong life for people with serious chronic and degenerative illness.

Western medicine basically has no known "cures" for any chronic or degenerative illnesses only controls. If you think I am wrong, please counter site, even one instance and I will remove this. I cannot provide thousands of articles proving no known cures for everything. Most people would rather try a possible cure than submit to a lifetime of control substance with continued deterioration of the body due to the control substance. I'd personally rather die looking for a cure than succumbing to that system permanently.

Again my citation is there is simple no article proving that western medicine can cure anything degenerative or chronic, but rather only control it, and so it makes sense that we should be careful about how to criticize medicines that are in wide use that can cure these chronic illnesses. I don't have an article proving that this is true, as I have already explained it cannot be proven using the methods that are currently known and used to us. However I can say this, walk into the Long Hua TCM Hospital in Shanghai China, and observe what is going on there, many people are being cured of disorders that people would be on controls substances for life in my home country (Canada) it's all on record in the hospital, just have to ask for it and they can tell you about it and provide the documentation. Perhaps I will ask them for some to be provided here in the wiki with peoples names removed.

I just left the that hospital for a neck injury, and I am in 95% motion in 2 days, why because of TCM herbs, Tuina, Acupuncture and Traditional Bone setting, all performed in the same hospital along side western medicine. What did the western side of the hospital offer? X-rays, MRI and muscle relaxants and physiotherapy, all costing ten times as much and although the western portions would be covered by my insurance I opted for the TCM treatment out of my own pocket, because I would be back to work sooner and save my employer time and money as well as my own sanity. How do I know this, because I could barely move my neck an inch and I have had a previous injury before of this nature and it took nearly a full year to get to the point where I am today only two days later using TCM. Yes this is subjective evidence and cannot be used, but here I am in China experiencing this, all smoke and mirrors to you maybe, but to me it's the only way I will take treatment now unless I have an infection, or need surgery, then I will opt for western treatment.

The Chinese government grants wall hanging awards to TCM practitioners that cure diseases that are not curable by western methods. One doctor in Yunnan Province has more than a dozen of them on his walls of them and has people lined up overnight to see him , my girlfriend saw him for a serious menstrual blood loss issue plaguing her for several years rendering her very weak and with low energy at most times of the day. We camped overnight to see the guy. I thought she was crazy, but she looks vibrant and healthy these days and several mothers came down the hallway to show their baby to the doctor in the course of one day while we were there, these mothers had all been diagnosed by western medicine to little or no possibility of childbirth and were not able to get pregnant before seeing this doctor. I was treated for digestion issues by him at the same time diagnosed as irritable bowel syndrome, what does western medicine have for that?, a big fat control pill that hurts your liver over time no thanks I won't chose to pay for a pill for the rest of my life I will take chance even given any criticized risk that Chinese medicine is ineffective, or damaging, as I don't see any evidence that western medicine is more safe in any way to be honest based on side effects and known issues for any given drug. I even asked my western doctor will this pill damage my liver? And he says "It may". No thanks I said, I'll take the risk of Chinese herbs and have a solution in a few days to a few weeks and then not have to take any more medicine for several years or months until I happen to have a different issue.

So my criticism is why is it that people up to 2000 years ago could find resolutions to these chronic problems and our science of today cannot find a solution to these issues?

My answer is simple, the scientific method simply cannot be used to prove everything, and is too narrow minded, so we need to expand our view of the scientific method and adapt it to be flexible enough to perform tests.

Also we are looking too narrow in our understanding of the human body we break down our organs into organs rather than systems of organs as the ancient people did.

I believe I Have countered all your criticisms save one, the risk and danger aspect, well you are right there are risks, but here is some interesting evidence from recent times [10]

Do you think more than 400,000 people die from misuse of traditional Chinese medicine every year? No sir, find me an article that shows how many actual deaths by Chinese medicine? And that's only in the U.S. alone. Somehow I'm just not afraid of Chinese medicine, especially if you consider the alternative which there really isn't one unless you go with the other traditional medicines I mentioned above. How about the statistics of how many people get liver poisoning from western medicine? Several western drugs that damage the liver: [11]

Citing government statistics, Xinhua reported recently that H7N9-virus patients had a mortality rate of just 9.1 percent if treated with a combination of TCM and Western methods, whereas one in three patients who relied on Western medicine alone died. What does that tell you? that TCM is indeed saving lives in China.

Also In 2011 a Chinese scientist received an award after drawing on Chinese medicine to produce the key ingredient in the world's leading anti-malaria drug. Tu Youyou of Zhejiang province received the award for her decades-long work in isolating artemisinin from sweet wormwood.

This woman used ancient Chinese traditional texts to discover and extract a cure for Malaria, a cure that had been known for two thousand years and made more potent by modern extraction process. You want to hear about effectiveness, ask the world health organization how well Artemisinin worked on the borders of Thailand and Vietnam where the normal chemical drugs stopped working as the parasite became immune to it. While the author of this drug implored the scientific method to prove what she had found she used a well known herb that fights parasites in Chinese Medicine. We need more of this kind of citation in the article in regards to what TCM has done and great achievements that have been made with the help of Chinese medicine. — Preceding unsigned comment added by Isaacegglestone (talkcontribs) 08:26, 11 February 2014 (UTC)


Sandbox

A high percentage of relevant studies on Chinese herbal medicine (CHM) are in Chinese databases. Fifty percent of systematic reviews on CHM did not search Chinese databases, which could lead to a bias in the results.[18] Many systematic reviews of CHM interventions published in Chinese journals are incomplete, some contained errors or were misleading.[19]

A 2012 review found TCM seems to be effective for the treatment of fibromyalgia but the finding were of insufficient methodological rigor.[20] A 2012 Cochrane review found insufficient evidence to support the use of TCM for patients with adhesive small bowel obstruction.[21] A 2005 Cochrane found insufficient evidence for the use of CHM in HIV-infected people and AIDS patients.[22] The research on the benefit and safety of CHM for idiopathic sudden sensorineural hearing loss is of poor quality and cannot be relied upon to support their use.[23] There is low quality evidence that suggests CHM improves the symptoms of Sjogren's syndrome.[24] A 2013 Cochrane review found inconclusive evidence that CHM reduces the severity of eczema.[25]

Edits on "Legal and political status" vol. I

User:QuackGuru was kind enough to add some material about the German acupuncture trials here... You know, the set of large trials that resulted in acupuncture being added to the list of reimbursable services in the German statutory health system.
Interestingly, the text that was added by QG reads: "As a result of the trial's conclusions, some insurance corporations in Germany no longer reimburse acupuncture treatments.[195] The trials also had a negative impact on acupuncture in the international community."
I try to AGF in this case, but unfortunately I know that QG knows that the GERAC resulted in acupuncture being reimbursable in Germany (as we have been working on that article together)... To leave this tiny fact out, and instead only present the side-note material about some health insurances allegedy not reimbursing acupuncture anymore and alleged negative impact on the international community, is a disgustingly obvious attempt to skew the facts. I know we have our differences in perspective here, but there're some rules for chrissake. If you're willing to skew the facts in this way, maybe you should stop for a minute and ask yourself whether your POV got the better of you.--Mallexikon (talk) 08:13, 26 December 2013 (UTC)

Agreed. On the second point, the "negative impact on acupuncture in the international community", I think the idea is that since the results of the study were that sham and real acu were equivalent, more people started questioning or doubting the efficacy of acupuncture. This needs to be better-phrased, and needs a source, although it is true. (It seems perverse that they decided to reimburse for acu even though it didn't do better than the placebo control, but I suppose the thinking is that the clinical choice isn't between real and sham, but between real acu and doing nothing. At any rate, as many editors know, some studies, and reviews[26], have found real acu statistically superior to sham, and there is no general agreement on whether acu in general is a placebo[27].) Regarding tendentious editing, I no longer belief QG is trustworthy when it comes to honestly representing sources or talk page discussion (see discussion at Talk:Acupuncture earlier this month, when four different editors criticized his conduct). --Middle 8 (talk) 14:09, 26 December 2013 (UTC)
Side note: I misplaced this thread. Should be at acupuncture. --Mallexikon (talk) 05:38, 20 January 2014 (UTC)

Drug research, continued

Discussion was forking into two sections above (MEDRS violations again and Drug discoveries), both of which were getting bloated. Let's continue here. --Middle 8 (talk) 09:09, 4 January 2014 (UTC)

Regarding the isolation of artemesinin from Artemesia Annua (Qing Hao or Qinghao), these edits reflect a misreading of the source:

  • [28]
  • [29] (scroll down to 2nd change, "It has been documented...")

What the source actually says: Usually TCM herbs are boiled, but in this case the scientist noticed traditional source that said Artemesia Annua should not be boiled, and decided to try cold extraction. Two more sources say the same thing: [30] [31]. I'm going to change the article accordingly.

The main point is that artemesinin, extracted from a particular herb, opened the door to a new class of antimalarial drugs. If some old doctor noticed that the herb worked better when not boiled, and science bears this out, it's hardly a dagger through the heart of rational skepticism! Let's not get caught up in the "TCM ROX!"/"TCM SUX!" divide. --Middle 8 (talk) 10:38, 4 January 2014 (UTC)

So it has gone from being a totally unproven alt med intervention to real medicine, no longer TCM. Well well. The TCM brigade should look at it like the difference between willow bark and aspirin. We have now got something that is measured and controlled and seems to work, as against the uncontrolled juju that we had before. Well done modern science. --Roxy the dog (resonate) 10:58, 4 January 2014 (UTC)
No doubt all parties involved would be honored by the condescension of today's science fans. --Middle 8 (talk) 07:40, 5 January 2014 (UTC)
The newly added text is misleading.
Here is verification for the previous text: "After reading the ancient Chinese medical description, “take one bunch of Qinghao, soak in two sheng (∼0.4 liters) of water, wring it out to obtain the juice and ingest it in its entirety” in The Handbook of Prescriptions for Emergency Treatments by Ge Hong (283–343 CE) during the Jin Dynasty, she realized that traditional methods of boiling and high-temperature extraction could damage the active ingredient. Indeed, a much better extract was obtained after switching from ethanol to ether extraction at lower temperature. However, the extract was still toxic. Professor Tu then further removed from the extract an acidic portion that contained no antimalarial activity, leaving a neutral extract with reduced toxicity and improved antimalarial activity."[32]
The previous text is well sourced and accurate" "It has been documented that the traditional Chinese methods of high temperature extraction can damage the active ingredient in Artemisia annua.[109]" That means that Scientists started by studying traditional recipes, but found that by moving away from them and using a low-temperature ether-based extraction method, and by adding detoxification and purification processes, they could create a drug with sufficient active ingredient to be effective.
The newly added references does not seem to be MEDRS compliant and contradicts the previous source used. QuackGuru (talk) 19:48, 4 January 2014 (UTC)
Its OR on your part. TCM practitioners use extracts developed by "scientists" all the time. Its standard practice, not mutually exclusive. 20:14, 4 January 2014 (UTC) — Preceding unsigned comment added by Herbxue (talkcontribs)
TCM practitioners use extracts is not the issue here. According to the source the text I added is sourced. QuackGuru (talk) 20:20, 4 January 2014 (UTC)
@QuackGuru, re quoted sources: "She suspected that extraction at high temperature destroyed the active ingredient of qinghao. She went back to the traditional medicine book and, after reading about a preparation that called for soaking qinghao with cold water, proposed using a low boiling point solvent to extract the active chemical."[33] That's from another source talking about the exact same research, and it's saying the same thing as the quote from Cell [34] that QG posted above. Most TCM herbs are boiled, but there are many that are not, including Artemisia (qing hao), according to the traditional source Dr. Tu used. My edit makes that clear; QG's edit (scroll down) reflects a misreading of the source(s). --Middle 8 (talk) 07:02, 5 January 2014 (UTC)
"After reading the ancient Chinese medical description, “take one bunch of Qinghao, soak in two sheng (∼0.4 liters) of water, wring it out to obtain the juice and ingest it in its entirety” in The Handbook of Prescriptions for Emergency Treatments by Ge Hong (283–343 CE) during the Jin Dynasty, she realized that traditional methods of boiling and high-temperature extraction could damage the active ingredient.[35]
"She suspected that extraction at high temperature destroyed the active ingredient of qinghao."[36]
The active ingredient is destroyed by high temperature. My edit made that clear. She proposed using a low boiling point solvent to extract the active chemical because boiling damaged the effectiveness of the extract. QuackGuru (talk) 16:33, 5 January 2014 (UTC)
I don't disagree with you that boiling destroys the active ingredient. I did disagree with your spin that one particular traditional source said not to boil it, but now that two more sources clarify this point, we're fine. All I objected to now was your wording, which was unclear. I made one small change, "an" to "the", to clarify that boiling destroys the active ingredient not in "an" extract (any extract), but in "the" particular extract from Artesmesia. [37] Are we done? --Middle 8 (talk) 01:48, 6 January 2014 (UTC)
Almost done. I think it would be better to clarify what is the extraction process for the drug. QuackGuru (talk) 04:39, 6 January 2014 (UTC)
Rather a "low level detail", isn't it? But fine with me. --Middle 8 (talk) 02:17, 7 January 2014 (UTC)
It was important to clarify the type of extraction process. QuackGuru (talk) 02:42, 7 January 2014 (UTC)
The editor whose diff you cite misread the source[38] just as much as you did. Dr. Yu (20th century) decided to do cold extraction after reading Dr. Ge (4th century) saying Artemisia shouldn't be boiled (unlike most TCM herbs). (See other two sources that clarify. [39][40]) How complex is that? What you're adding is "TCM-sux" POV-pushing meets sloppy reading. --Middle 8 (talk) 04:58, 7 January 2014 (UTC)
I removed the peripheral material. --Middle 8 (talk) 05:05, 7 January 2014 (UTC)
"Indeed, a much better extract was obtained after switching from ethanol to ether extraction at lower temperature. However, the extract was still toxic. Professor Tu then further removed from the extract an acidic portion that contained no antimalarial activity, leaving a neutral extract with reduced toxicity and improved antimalarial activity."[41]
Dr. Yu (20th century) decided to do cold extraction after reading Dr. Ge (4th century) but it still required further processing to make an effective drug. This tells the whole story. QuackGuru (talk) 05:10, 7 January 2014 (UTC)

That belongs at artemesinin, or Artemisia annua. Your take on a "low level detail" is completely self-serving -- over at acupuncture you insisted that having more than one sentence summarizing a large meta-analysis on acupuncture for pain was a "low level detail" [42] (discussion). And now here, in a subsection on a single herb, you want nearly twice as much detail! Look, we get that you think TCM is quackery, and want to highlight the science.... well, except when the science supports TCM, apparently .... and we all understand WP:FRINGE. But your WP:TE is making for worse articles. --Middle 8 (talk) 07:07, 7 January 2014 (UTC)

I think (judging in part from a message from Middle 8 on my Talk page) there are some crossed wires here. From an older version of the article it was particularly important to clarify this was a modern industrial drug because the material was in the Herbal medicines/Efficacy section (thus implying, if we didn't take care, that artemesinin is an efficacious herbal medicine). Subsequent new section names have largely removed the requirement for this to be done. It's a detail that is okay to have, but should probably be in the detail article rather than here. Alexbrn talk|contribs|COI 09:24, 7 January 2014 (UTC)
Current text: "The extracted substance, once subject to detoxification and purification processes, is a usable antimalarial drug[109] – a 2012 review found that artemisinin-based remedies were the most effective drugs for the treatment of malaria.[112]"
This sentence must stay or the reader will think that artemesinin is an effective herbal medicine. It must be processed to work. QuackGuru (talk) 20:18, 7 January 2014 (UTC)

Detail

A lot of the detail under discussion would be better moved to our Artemisinin article. What is said there can then be summarized here. Alexbrn talk|contribs|COI 09:22, 5 January 2014 (UTC)

The cold extraction thing above isn't (yet) in that article, so we'll move it there once it's finalized here. --Middle 8 (talk) 01:49, 6 January 2014 (UTC)
I moved the cold extraction bit and other information to the main article. QuackGuru (talk) 04:53, 6 January 2014 (UTC)
@QG - Which article do you mean? (obviously not Artemisinin; no changes there yet) --Middle 8 (talk) 01:52, 7 January 2014 (UTC)
Artemisia annua. QuackGuru (talk) 01:55, 7 January 2014 (UTC)

Agree most of the detail here should be dispersed. The one "link" between TCM and Artemisinin is Tu's claims about the link between old recipes and her discovery (+ the reaction to that); so somehow or other that should stay. Alexbrn talk|contribs|COI 08:14, 7 January 2014 (UTC)

I'm note sure what should be kept or moved to other articles. QuackGuru (talk) 06:51, 8 January 2014 (UTC)
The (nice) problem is new stuff keeps coming to light: new sources from Middle 8 and yesterday I found our Tu Youyou article. I'm inclined to think what should probably end up here is something like:

Artemisinin is an antimalarial drug based on an extract of Artemisia annua, a herb traditionally used as a fever treatment[ref]. Tu Youyou, the scientist who discovered it, claims to have been influenced by a traditional 4th century recipe.[ref]

This way, the three wikilinked articles can then "take the strain" of all the additional details. Alexbrn talk|contribs|COI 08:03, 8 January 2014 (UTC)
I think it would be best to move the text to other articles and then it can summarised here. QuackGuru (talk) 09:00, 8 January 2014 (UTC)
Are folks happy with my "two sentence" proposal above? If so, I'll happily spread the content through the articles ... Alexbrn talk|contribs|COI 09:02, 8 January 2014 (UTC)
I think that might be a little too short but I do not have any serious objections. From the very beginning I thought the new section was a WEIGHT violation. QuackGuru (talk) 09:11, 8 January 2014 (UTC)

From reading the sources, I think there are three general details we need to include here to round-out the picture:

  1. That the impetus for much of the research also came from a big state-driven program to find drugs
  2. When these discoveries happened (nearly 50 years ago for artemisinin)
  3. The very low "hit rate"; there seem to have been thousands of herbs tested

Alexbrn talk|contribs|COI 09:26, 8 January 2014 (UTC)

Your original proposed wording looks good to me. Not sure about #3 above for additional details - it would have to be properly contextualized and not used to synthesize a point about the limited viability of TCM herbs in general.Herbxue (talk) 03:18, 9 January 2014 (UTC)

Reference 111 failed verification?

http://www.researchgate.net/publication/7212235_The_history_of_qing_hao_in_the_Chinese_materia_medica

This reference does not seem to verify the claim. QuackGuru (talk) 20:24, 7 January 2014 (UTC)

Chairman Mao Reinvented Traditional Chinese Medicine?

“Even though I believe we should promote Chinese medicine,” Mao told him, “I personally do not believe in it. I don’t take Chinese medicine.” QuackGuru (talk) 06:36, 9 January 2014 (UTC)

You can always rely on Mao to provide an appropriate quote. --Roxy the dog (resonate) 06:44, 9 January 2014 (UTC)
We can add this quote and summarise the article. Read this. "The reason so many people take Chinese medicine seriously, at least in part, is that it was reinvented by one of the most powerful propaganda machines of all time and then consciously marketed to a West disillusioned by its own spiritual traditions." Lots of stuff to write. QuackGuru (talk) 06:55, 9 January 2014 (UTC)
This article has already been rejected by previous consensus. You will need consensus to include it now and I do not approve. The author is not an expert on TCM, China, or Mao, check his webpage. He is a blogger that is an attention seeker. THe article's main point is to criticize the U.S. government for Naturopathic legislation. It is not appropriate here. Herbxue (talk) 17:11, 9 January 2014 (UTC)
I think the Old Guard should make way for the new republic on this. Just because you do not approve doesn't mean we wont have consensus. Consensus easily changes - the article looks acceptable to me, and the author is is an assistant professor of Chinese philosophy and religion at James Madison University, not just a blogger. --Roxy the dog (resonate) 17:46, 9 January 2014 (UTC)
What is the argument of his article? It is to make current U.S. Senators look foolish for supporting naturopathic medicine by using a very sensationalist argument about Mao, a larger than life dartboard for conservative critics. It is not a good faith effort to explain TCM - if it was he would have actually delved into how the diverse source texts were summarized into a cohesive theory in the early 1900's by people like Zhang Xichun and Qin Bowei, and how their efforts lead to the creation of standardized textbooks written and revised by expert consensus over the next 60 years - Mao had nothing to do with the "creation" of TCM, he only recognized it as a cost effective option and promoted it as such. It is true that the prevailing Marxist thought lead to the removal of some spiritual/psycho-emotional theories from the standard texts, but that trend had started LONG before 1949 (read Unschuld, Medicine in China). If you don't know anything about the history of TCM, of course "the article looks acceptable" - that's the problem! The article is ill-informed AT BEST, is likely disingenuous, and is not appropriate here. Herbxue (talk) 18:11, 9 January 2014 (UTC)
I don't think that US Senators who support non evidence based therapy need this article to make themselves look foolish. They do it very well for themselves. You'll be saying you agree with Mao on cost effectiveness next.
I am interested in the "cohesive theory" of TCM you describe, and the expert consensus that led to the standard textbooks that give us this world class system of medicine. It works so well it is taking over from real medicine so fast that Evidence Based Medicine's nose is bleeding. You have to bear in mind that that cohesive theory is just nonsense, and your expert consensus is a joke. TCM certainly has cultural and historical significance, but medically, it is a redundant backwater. --Roxy the dog (resonate) 19:03, 9 January 2014 (UTC)

Whether you are correct about that or not, it is not the issue here, and the fact that your opinion is so clear shows why you are not able to be objective about the source in question here. You like it, perhaps because it fits your "TCM is foolish" narrative, but that is not a convincing justification for inclusion of this source.Herbxue (talk) 21:41, 9 January 2014 (UTC)

Ginger

Ginger should be included in this article. If there is an issue with the text then rewrite. QuackGuru (talk) 18:32, 7 February 2014 (UTC)

Another source.[43] QuackGuru (talk) 19:31, 9 February 2014 (UTC)

If a source mentions in in relation to TCM, then yes. But we need to avoid poor sources and original research. Alexbrn talk|contribs|COI 19:37, 9 February 2014 (UTC)
The source says it does have anti-inflammatory properties. Did you delete that part by accident or did you do it intentionality. QuackGuru (talk) 20:17, 9 February 2014 (UTC)
Intentionally. The source says there is no firm evidence of clinical worth, so we don't mention things in the "Efficacy" section of a medical article unless there is well-sourced evidence of efficacy. Alexbrn talk|contribs|COI 20:22, 9 February 2014 (UTC)
I was not asking about its clinical worth. That is a separate issue. The source said: "Also ginger (Zingiber officinale Roscoe, Zingiberaceae) besides its status as a spice and food item, has become a global medicinal commodity used against rheumatism, headache and above all against digestive and respiratory problems showing potent anti-inflammatory properties in vitro and in vivo (Chevallier, 2000; Williamson, 2002; van Breemen et al., 2011)." The part that it does have anti-inflammatory properties is not debatable. QuackGuru (talk) 20:31, 9 February 2014 (UTC)
You need to pay attention to context. But mentioning anti-inflammatory properties in an "Efficacy" section in the context of treatment of human health conditions, and omitting the fact that these "properties" are in the laboratory only, you give the reader the impression that these are clinical properties. But in fact the source says "Well-conducted clinical trials on the therapeutic efficacy and effectiveness of ginger preparations in painful inflammatory conditions are, however, still lacking". So you are presenting the information in a way which is nearly 180° opposite to what's in the source, which is not good. Alexbrn talk|contribs|COI 20:38, 9 February 2014 (UTC)
That is a separate point. QuackGuru (talk) 20:44, 9 February 2014 (UTC)
I made this change because that is what the source says. QuackGuru (talk) 04:52, 11 February 2014 (UTC)