Talk:Homeopathy

To Do List

add explanation of healing crisis in the context of homeopathy, and how this relates to how homeopathy is claimed to work, including both the homeopathic explanation, and the conventional medical critique. add a broad-brush description of the work of Constantine Hering and James Tyler Kent and how it differs from Hahnemann, keeping the depth of coverage appropriate for a summary article. Kent is noted for "the well-known Kent repertory, on which virtually all modern practise of homeopathy is based" homeopathic hospitals in the late 18th and early 19th centuries were attended by the rich and powerful as the best locations where one could get better. They were relatively clean and calm institutions that had a better cure rate than many of the mainstream clinics of the day. Of course, this was due to the fact that most mainstream hospitals of the day were filthy places where one was more likely to die of an infection rather than be cured. In this, homeopaths of that era were closer to the do no harm dictum of the Hipocratic Oath than many of their contemporaries and, indeed, many practices perfected in homeopathic hospitals are still employed today as best practices for palliative care. The fact that they didn't use the "heroic" measures in common use, such as bloodletting, powerful drugs like arsenic, strychnine, mercury, belladonna, etc. meant that more patients survived, since these drugs often caused more deaths. In many cases doing what amounted to nothing, i.e. placebo homeopathic treatment, was better than doing something, i.e. overkill with poisons, thus letting the body's own recuperative powers do the healing, which for many ordinary ailments is just fine.

Request to change wording about "placebo"

Hi everyone, I'm sort of new to Wikipedia so please excuse if I'm breaching protocol here. My request is if we could please change the setence in the first paragraph that reads "The collective weight of scientific evidence has found homeopathy to be no more effective than a placebo." Please could we change it to say that "The collective weight of scientific evidence has found homeopathy to be as ineffective at treating ailments as a placebo." To say that it is "no more effective" could lead the reader to incorrectly conclude that a placebo may have some effectiveness, and therefore so might homeopathy. By saying "as ineffective as", we remove any such potential ambiguity. Thank you. 78.105.47.23 (talk) 20:42, 1 November 2011 (UTC) McPhee

If you read the article Placebo, and the references at the end of the statement in the article, you should see why the present wording in this article agrees with the references. Ward20 (talk) 06:06, 2 November 2011 (UTC)

I agree that technically, the wording "as ineffective as" is essentially the same as "is no more effective than" - and that using the former leaves a stronger impression as to the ineffectiveness of homeopathic treatments. But I don't think we should make it sound like homeopathic treatments have no effect whatever on the human body (ie less than placebo). The trouble is that placebo is effective to some small degree in some areas of medicine. "no more effective than" is a good description of what homeopathy does. To someone who believes in all that nonsense, there is a small statistical benefit to taking homeopathic medicines over taking no treatment at all. So, while I'm fully in agreement that homeopathy is ridiculous junk pseudoscience, we shouldn't be saying that it doesn't do anything. It does exactly what you'd expect a small dose of pure water to do if you can make it seem to the person taking it that it's going to fix what ails them...and that's not "ineffective". So I'm not really inclined to the proposed change.

As an aside, here at Wikipedia, we don't generally need to ask permission to make an edit. One of our founding guidelines is "be bold". If you think a change is good - then just go and make the change yourself. If it's non-controversial - then it will likely 'stick' and become a long-term part of the article. If one or more people dispute it - then it'll likely get reverted pretty quickly - and then we should discuss the change here on the talk page. But in general, it saves time if you just make your change directly rather than asking first. SteveBaker (talk) 12:34, 2 November 2011 (UTC)

Way up above in an older thread, LeadSongDog suggests: "indistinguishable from placebo effect". Perhaps that is better wording than either "as ineffective as" or "is no more effective than"? I'd support that change. SteveBaker (talk) 12:38, 2 November 2011 (UTC)

That sounds like reasonable phrasing. We shouldn't forget that the apparent efficacy of placebos is a rather slippery thing that can be modulated in a host of ways, and the mysticism around the homeopathic belief system has evolved to maximize the placebo effect. (Everyone's seen this study from 2008, which found that more expensive placebos were more effective for controlling pain than discount placebos, right?) In the words of Philip K. Dick, "Reality is that which, when you stop believing in it, doesn't go away." TenOfAllTrades(talk) 12:55, 2 November 2011 (UTC)

"indistinguishable from placebo effect" is perfect, IMO. Anyone against this proposed change?JoelWhy (talk) 14:37, 2 November 2011 (UTC)

Sounds good to me. Here are two possible phrasings:

• "The collective weight of scientific evidence has found homeopathy to be indistinguishable from a placebo."

• "The collective weight of scientific evidence has found the effect of homeopathy to be indistinguishable from a placebo effect."

Brangifer (talk) 15:09, 2 November 2011 (UTC)

I prefer the second of the two, as we are describing the effect, not the substance.JoelWhy (talk) 15:12, 2 November 2011 (UTC)

No, because a placebo control controls for far more than just the placebo effect. It also controls for things like spontaneous remission, the natural history of the disease, and regression to the mean, which are not part of the placebo effect. The term "placebo effect" does not belong in that sentence. Brunton (talk) 23:37, 2 November 2011 (UTC)

Strictly speaking those aren't part of the placebo effect, but in practice they are usually included, so I agree. The first wording avoids that can of worms and is still accurate. -- Brangifer (talk) 00:51, 3 November 2011 (UTC)

Hmmmm, come to think of it, just saying "homeopathy" can be understood to mean the whole encounter, and we know that the attention of a caring person, especially charming quacks, can influence the placebo effect. Therefore I suggest a slight alteration of the first of my two sentences:

• "The collective weight of scientific evidence has found that the effect of homeopathic preparations is indistinguishable from the effect of placebos."

Even better is this one using a reference we already use:

• "The collective weight of scientific evidence has found that the effect of homeopathic preparations is indistinguishable from "placebo therapy at best and quackery at worst."

Brangifer (talk) 01:01, 3 November 2011 (UTC)

I'm not sure that's a helpful change, since a placebo conversation with a helpful person will still deliver the same result. If we take a narrow view and look at a placebo as a simple pill, then its effects are the same as a homeopathic pill. If we take a broad view and look at the whole experience, then the effects of the placebo experience (including a discussion with somebody who puts on a white coat and uses nonsense medical terms that are plausible-sounding to the subject) will still be the same as the homeopathic experience. So, I think we're better off sticking with the existing summary, although maybe we could go into more detail further down in the article. bobrayner (talk) 12:10, 3 November 2011 (UTC)

Some studies took into account the whole homeopathic package (individualized attention, custom-made preparations, etc.). In Homeopathy#Meta-analyses, near the end, in source Shelton 2004 (which happens to be broken) --Enric Naval (talk) 12:19, 3 November 2011 (UTC)

To the first suggestion: it isn't the "effect of placebos" that it is indistinguishable from, it is the placebo effect plus all the other things a placebo is used to control for. I'm afraid the second one is just a horrible sentence. I would also question including "...the effect of homeopathic preparations...". "No more effective than placebo" means that the preparations have no specific effects.

As far as I'm concerned either "...has found that homeopathic preparations are no more effective than a placebo" or "...has found that homeopathic preparations are indistinguishable from a placebo" would be OK, with the former preferred. Brunton (talk) 12:28, 3 November 2011 (UTC)

===Why is the word placebo even mentioned in the introduction? The German wiki pages don't mention it. In fact their wiki page has more correct information. When anyone goes to any doctor, placebo is part of the treatment, the doc believes all the other doctors beliefs. All humans have beliefs. Most of the people who have written this article have beliefs that homeopathy is placebo. That is their belief. I thought we were supposed to stick to the facts. Homeopathy is a form of medicine. Full Stop. Whether you like it or not. Doctors, vets, psychiatrists, and 'people' use it, practice it, write about it, have it in their homes, build hospitals for it, treat patients with it, write books about it, make remedies for it. The word placebo doesn't make this article 'Neutral' Objectivity_(journalism) at all. It makes it biased. Go to the German wiki page and have a read and you'll see what I mean....unless of course you're not multi-lingual.... Veryscarymary (talk) 09:41, 30 December 2011 (UTC)

"Why is the word placebo even mentioned in the introduction?" Because it is a term used by the sources used in the article, as something that homoeopathy has been compared with.

"The German wiki pages don't mention it." From the lead of the German Wikipedia article: "Klinische Studien nach wissenschaftlichen Standards konnten keine über den Placebo-Effekt hinausgehende Wirksamkeit homöopathischer Arzneimittel nachweisen." Brunton (talk) 10:25, 30 December 2011 (UTC)

Actually, the de.wiki article is quite similar to the en.wiki one, even though ‘the en.wiki article is much more neutral’ is a somewhat frequent argument over at the de.wiki talk page. --Six words (talk) 10:44, 30 December 2011 (UTC)

"Belief"

Hello everyone, it's McPhee here again.

I notice in the first line it says "Homeopathy is a form of alternative medicine in which practitioners treat patients using highly diluted preparations **that are believed** to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient."

Perhaps we could change this so that instead of saying "that are believed...", it reads as: "that some people believe..." or even "that they [the practitioners] believe..."

Because, not everybody shares the belief that homeopathy actually does anything. The way the first paragraph is written implies that mankind as a whole has some sort of belief in the effectiveness of homeopathy but doesn't have the evidence to prove it yet. I think we need to remove the ambiguity and make it clear that only some people believe in this. — Preceding unsigned comment added by 78.105.47.23 (talk) 19:57, 10 November 2011 (UTC)

Nice catch, you are correct.JoelWhy (talk) 20:35, 10 November 2011 (UTC)

Actually, now that I'm re-reading the sentence, I believe it needs additional changes. It states "practitioners treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient." If I am not mistaken, this is inaccurate. The practitioners believe the substance being diluted causes "healthy people to exhibit symptoms..." They don't believe the diluted preparation cause those symptoms.JoelWhy (talk) 20:39, 10 November 2011 (UTC)

That's what I used to think, too, because most texts about homeopathy start with Hahnemann's original 'discovery', and then never get around to explaining such fine points of modern practice. But it is a fact that homeopaths nowadays use the diluted preparations on healthy people. This practice was started by Hahnemann. I forgot where I found this information in such a clear form that I couldn't continue to entertain my illusion on this point, but it's in the talk page archives somewhere. Hans Adler 09:25, 11 November 2011 (UTC)

• JoelWhy, that sentence is confusing because it blends two things: (1) the proving and (2) the final remedy. It's simply an awful sentence.

• Hans, yes we do base our information about provings on one RS, to the exclusion of lots of other RS to the contrary. What do we do? This has been a problem in the article for a very long time. I mentioned this a long time ago and then dropped it. There's apparently a conflict within the homeopathy world about provings. One source we use and give a lot of weight, makes the proving and final remedy identical (both are ultra diluted). Other sources make it clear that the proving is undiluted and used on healthy individuals, and the symptoms caused are recorded. Then a highly diluted remedy is prepared and given to sick people who have the same symptoms that were caused by the original, undiluted, substance used in the proving. That makes sense from a homeopathic POV. The other scenario (both are the same) doesn't makes sense since an undiluted substance used in a proving isn't going to cause any dramatic symptoms to even record. So how can this be done at all? I know I'm asking for logic from within the illogical worldview of homeopathy, but what to do? -- Brangifer (talk) 16:21, 11 November 2011 (UTC)

I think we can resolve part of the confusion by not mentioning provings in the first paragraph. We are alluding to it and that muddles the waters. Provings aren't used to "treat" anyway. -- Brangifer (talk) 16:25, 11 November 2011 (UTC)

I always have difficulty with text that asserts someone's belief, especially when it is a belief in something widely held to be impossible. How can we enable a reader to verify an assertion of a subjective belief? At most they can verify that the belief was claimed, but never that it was held. As some actor says regularly, "everybody lies". LeadSongDog come howl! 20:52, 10 November 2011 (UTC)

(That would be Hugh Laurie as Dr Gregory House)

Anyway...in this case it is not at all clear that the practitioner 'believes' that the homeopathic treatment will work...who knows? Maybe they're just in it for the money. Selling people water at $20 a bottle is a profitable business...and it's quite possible that the practitioners don't believe it for a moment. The only people who are certain to believe in it are the patients - what motive would someone have to going to a homeopathist and drinking their expensive water if they didn't believe in it? So (IMHO), we have evidence that the patient is the "someone" to whom we're referring - and the practitioner is the one whose true beliefs are unknown and unknowable because their actions could be those of someone of good moral character who genuinely believes that they are curing people - or someone of despicable character who is syphoning money from the genuinely sick and the gullible. So the strongest statement would have to be that the patient believes it, that mainstream science does not believe it and that we don't know about the practitioner's beliefs. SteveBaker (talk) 21:22, 10 November 2011 (UTC)

You could change "believed" to "claimed". As in, "practitioners claim the substance being diluted causes healthy people to exhibit symptoms..." (or, something along those lines.)JoelWhy (talk) 21:26, 10 November 2011 (UTC)

If we really want to tell it like it is....we could write "that practitioners tell patients".....;-) OK, maybe not THAT snarky, but it's the truth. -- Brangifer (talk) 03:03, 11 November 2011 (UTC)

Hard to verify though, as it's privileged communication, isn't it? How about "Homeopaths teach that..."? LeadSongDog come howl! 06:17, 11 November 2011 (UTC)

I would prefer "claim" in this case. It is what they're claiming, and that claim is wholly rejected by the academic community, so WP:CLAIM shouldn't be an issue. "Teach" implies, in some small way, that they're imparting knowledge, as opposed to asserting claims.   — Jess· Δ♥ 06:24, 11 November 2011 (UTC)

I also Like "claim" Tal Galili (talk) 10:49, 11 November 2011 (UTC)

What if we were to change it to something along the lines of "According to practitioners..."? This removes the potential bias charge of the word "claims" yet makes it clear to the reader that it's an assertion made exclusively by the homeopaths. I hope I don't sound like I'm trying to defend homeopaths (and, if I do, I will make sure to say three Hail James Randi's before I go to sleep tonight) but there's really no need to give them ammunition for a bias charge. They're trying to cure themselves with magic water, so the facts pretty much speak for themselves.JoelWhy (talk) 13:43, 11 November 2011 (UTC)

The latest change uses "practitioners claim to treat patients..."...but that's not right either, surely. They actually do 'treat' them - it's just that the treatment doesn't work. Their claim is that the treatment will work. We could say "practitioners claim to effectively treat patients..." - but I don't really like that either. SteveBaker (talk) 15:31, 11 November 2011 (UTC)

I just had a wild thought...can homeopathy effectively treat dehydration? Take a small drop of water and dissolve it in a hell of a lot of water, then have the patient drink it!  :-) SteveBaker (talk) 15:31, 11 November 2011 (UTC)

Close, but not quite. Remember that the homeopathic remedy is made from a substance which, in large quantities, produces the symptom—not cures it. For dehydration, you'd want to start with something like salt, or ethanol. You're right, though, that the homeopathic preparation of salt – with sufficient dilution and administered in adequate volume – would cure dehydration, and it's a wonder that such a product isn't already in stores. Homeopathic preparations of alcohol, meanwhile, are already available over-the-counter—visit your local bar and ask for any mass-market American lager. TenOfAllTrades(talk) 16:22, 11 November 2011 (UTC)

Ah: Miller-Lite - a homeopathic C6 dilution of alcohol and beer-like flavorings with a dash of undiluted artificial colouring to make it look more like urine. SteveBaker (talk) 17:11, 11 November 2011 (UTC)

Hmmm - you're right though. A small drop of water, diluted in a hell of a lot of water would simply dehydrate the patient even more than they were before! I think I'm getting the hang of this new wonder-science. SteveBaker (talk) 17:14, 11 November 2011 (UTC)

It's been done http://www.hominf.org/aquanova/aqnointr.htm. You just can't make this stuff up, well you can I suppose Acleron (talk) 00:37, 12 November 2011 (UTC)

So, how does a homeopath treat someone suffering from water intoxication (i.e. over consumption of water)? Since the cause of the illness is water, do you treat it with diluted water? I think my brain is about to explode...JoelWhy (talk) 20:26, 11 November 2011 (UTC)

Probably with diluted espresso. LeadSongDog come howl! 20:38, 11 November 2011 (UTC)

No, wait, you're right! Now for that headache, how about some diluted ice cream? LeadSongDog come howl! 20:41, 11 November 2011 (UTC)

[reply to TenOfAllTrades]: "Remember that the homeopathic remedy is made from a substance which, in large quantities, produces the symptom—not cures it." No, it is the remedy itself that is alleged to cause the symptoms, not whatever it is made from. Brunton (talk) 21:51, 11 November 2011 (UTC)

See, for example, the "proving" that Acleron has linked to above. Brunton (talk) 23:33, 12 November 2011 (UTC)

Brunton is correct, it's the preparation after dilution but many are coincidentally the symptoms of the original material. But I do wonder what a 200C dilution of vacuum will do. https://www.helios.co.uk/cgi-bin/store.cgi?action=linkrem&sku=vacu — Preceding unsigned comment added by Acleron (talk • contribs) 05:12, 13 November 2011 (UTC)

Oh my! The results of combusting brown's gas in homeopathic dilutions?! That's a fringe theorist's wet dream! Brown's gas is what you get from the electrolysis of water (see Oxyhydrogen) and it's just a stochiometric mixture of hydrogen and oxygen - but that doesn't stop the crazies from claiming all sorts of bizarre properties for it...98% of which end up in you being able to run your car on water. The idea of homeopathic browns' gas reaction byproducts (ie water, dissolved in water) is just too good to miss!

I bet that's what they feed the Aliens at Area 51 on to keep them happy while they're being forced to participate in faked moon landings with Elvis (who, of course, is in hiding after a certain incident on the grassy knoll). I suppose that's what keeps their Indigo auras in top condition.

SteveBaker (talk) 02:05, 15 November 2011 (UTC)

Evidence-based homeopathy???

A recent article in the BMJ The NHS is right to fund homoeopathy generated a lot of responses, one of which was entitled Rational Homeopathy? http://www.bmj.com/content/342/bmj.d2642?page=1&tab=responses (It’s about two-third down the page)

It describes a specific clinical scenario (dealing with anxiety when weaning a diabetic patient off some of the drugs she may not need anymore) where using a homeopathic ‘remedy’ may benefit the patient. Both doctor and patient accept that they may be dealing ‘only’ with a placebo effect, so no deception is involved, and if it helps the patient to stay off the drugs, its use should surely be justified as a perfectly ‘rational’ and evidence-based intervention?

The author of the response (me) finishes with a flourish:

Homeopathy is part of the rich medico-cultural tradition in Europe. It's safe and (in this scenario) its use is evidence-based. Why stop it in the NHS? Why smash a butterfly on the unfeeling wheels of legislation? Why drive patients into the arms of quacks?

I have shown this response to a number of science-minded friends but we can’t fault its reasoning. Should I add a note on this specific possible justified use of homeopathy to the WP article? Sleuth21 (talk) 16:58, 14 November 2011 (UTC)

The short answer is "No". It's a reader response (I have written them for the BMJ too, but I wouldn't consider them eligible here...), so it's not a RS, much less a WP:MEDRS. Adding it here would amount to adding your OR in a primary source to the article. That's why we require secondary sourcing. Your logic is also somewhat flawed, since, as you write, "no deception is involved", ergo you won't elicit a true placebo effect. Otherwise congratulations on getting your response printed. I recall getting lots of editorial help from them with my responses. -- Brangifer (talk) 17:15, 14 November 2011 (UTC)

If you can find a more reliable source which says much the same (I'm sure I've stumbled across it somewhere), that could be a good anchor for a mention in this article. Almost by definition, a placebo does still involve an element of deception, but if it actually helps patients... bobrayner (talk) 17:20, 14 November 2011 (UTC)

I can see something like this being added to the article on placebos, but here? I'm not sure. I mean, replace the word "homeopathy" with the phrase "reiki healing" or "witchcraft" or "spiritual healing by developing a psychic quantum link with a peanut butter and banana sandwich", and you'll end up with the same conclusion -- placebos may help, so what's wrong with that? Well, there's nothing wrong with that, but it has nothing to do with the homeopathic "remedy". It's just a placebo. And yes, placebos in different forms may have more or less impact (e.g. injected placebo tends to lead to stronger reactions than in pill form.) But, it's still a placebo.JoelWhy (talk) 17:30, 14 November 2011 (UTC)

Admittedly, homeopathy is one of the most widely-recognised forms of placebo; many millions of people think it works. Whereas a typical patient is unlikely to take you seriously if you prescribe quantum entanglement with a variety of food products. (And one of homeopathy's louder supporters does like to use lots of sciency-sounding words like "quantum" to get around that irksome lack of evidence). bobrayner (talk) 17:51, 14 November 2011 (UTC)

Even if it worked as a placebo after the doctor has obtained informed consent to administering it - why should the NHS pay a homeopathy manufacturer $20 for 5 fluid ounces of water? If the placebo effect is all that it takes then why not fill little 50 cent plastic bottles with tap water and save $19.50 per "treatment"? If it turns out to be ethical (and legal) for a doctor to prescribe a placebo - then there are vastly cheaper ways to do that. Suppose we have doctors prescribe Orange TicTacs instead of homeopathic pills? Buycheapr dot com sells 24 packs of 50 tictacs] for $16. I'm sure they could be made much cheaper than that. That's about a penny a "pill" - contrast that to most homeopathic pills that cost around 25 cents a pill. Homeopathy sucks...even as a placebo. SteveBaker (talk) 01:49, 15 November 2011 (UTC)

Ah, but Steve—it's already been demonstrated that more expensive placebos are more potent that less expensive ones. The study found that $2.50 sugar pills were more effective than ten-cent sugar pills at controlling pain. I believe that there are also studies showing increased efficacy brought about by nice packaging. TenOfAllTrades(talk) 01:56, 15 November 2011 (UTC)

Yeah - but 24 cents a pill buys some pretty fancy packaging. Besides, this is prescription medicine - everything comes in identical orange pill bottles. If you have a fixed amount of money to spend on convincing the patient, you REALLY don't want to spend any of it on pointlessly diluting ingredients. Hence a true placebo will always be cheaper than a homeopathic treatment. 02:13, 15 November 2011 (UTC)

Thank you all for your comments. Perhaps I wasn't clear enough in my original suggestion (above). Here is a rephrased suggestion:

The clinical scenario mentions no active treatment but specifically discusses the discontinuation of unnecessary medication. Obscure theories describing an effect beyond placebo of homeopathic ‘remedies’ are not part of the argument in this context – certainly not the memory of water or ‘quantum wave vibrations’. Of interest is only the placebo effect of homeopathic ‘remedies’ which is well established (refs. available). It is equally well established (but not undisputed) that in some clinical situations the use of the placebo effect can be ethically justified, especially if the informed consent of the patient has been obtained (refs. available). It has even been suggested that it may unethical to withhold a placebo (refs. available).

The placebo effect is of course stronger (refs available) if both the patient and clinician belief (or accept as a possibility) that there is more to it, a situation most likely to occur in developed countries where homeopathy has a well established tradition among some qualified medics and many members of the patient-public.

Homeopathy is also unlikely to have any side-effects - obviously, it’s just water (refs. available). Other ‘alternative’ therapies which in addition to the placebo effect may have adverse effects (such as acupuncture, chiropractic, iridology, potent herbal remedies or weird voodoo stuff) are not part of the argument here.

The scenario also excludes the possibility that proper treatment is delayed. It takes place in a ‘regular’ family practitioner’s office where other diagnostic and therapeutic options have been considered, and the placebo effect is used to strengthen the patient’s resolve to stay off unnecessary drugs (refs available). …and finally:

‘Evidence-based medicine’ tries to integrate the best external evidence with the clinician’s acumen and the patient’s preferences. Both patient and clinician agree that homeopathy may help in the specific scenario described in this thread. It should, suitably wikified and referenced (from reliable sources (e.g. Cochrane, PubMed peer-reviewed, quality journals)), merit a short paragraph in NPOV mode in the WP Homeopathy article.(sleuth21) 87.194.69.72 (talk) 12:57, 21 November 2011 (UTC)

Perhaps all of those things are individually true and can be referenced - but to jump from that to writing something along the lines you suggest in our article would be a severe case of original research backed only by synthesis of published material that advances a position - both of which are specifically disallowed here. So, no - you can't write this into the article. SteveBaker (talk) 13:35, 21 November 2011 (UTC)

Thank you, Steve for your quick and apparently decisive answer. I am aware of both WP police guidelines you mention but neither applies to the points I would like to add to WP. They don’t constitute ‘original research’ and are no ‘synthesis [..] to advance a position’; they merely describe established ideas which can be described in a NPOV and wikified fashion, for instance in the form (I improvise): It has been suggested that the use of placebos may be ethical in certain circumscribed clinical situations (refs), with (refs) or even without the expressed consent of the patient (refs), or that the judicious use of a placebo may help in weaning some patients off addictive or unnecessary drugs (refs.). I would add brief relevant quotes from the pertinent refs., all of which from the 200 (or so) core Medline / PubMed peer reviewed journals. I may insert ‘not undisputed’ or similar where appropriate. These points should be mentioned in WP (as far as I can see they aren’t yet) and would enrich its encyclopaedic content in relevant articles. Some of the other points I raised in the remarks above dealt with possible objections; they would not be part of a WP article on e.g. placebos or homeopathy.

I think under the circumstances it is best if I step away from this discussion thread, let my points ‘breath’ a bit, and then add short sections to the relevant WP article, incl. the homeopathy article. Sleuth21 (talk) 19:39, 22 November 2011 (UTC)

In your improvised example you're using sources that don't specifically discuss homeopathy to imply that homeopathic "remedies" can be prescribed ethically - in my eyes that's synthesis. --Six words (talk) 20:56, 22 November 2011 (UTC)

Thank you, Six Words. As the effects of homeopathic interventions cannot be distinguished from that of placebo interventions (they are both placebo interventions), anything said about the judicious and ethical use of placebos applies also to homeopathic tinctures in a safe clinical setting. Isn't that simple logic or common sense, and not synthesis? Sleuth21 (talk) 13:10, 3 December 2011 (UTC)

WP:SYNTH is very clear on this: "A and B, therefore C" is acceptable only if a reliable source has published the same argument in relation to the topic of the article., so unless you cite a source making that statement, the example is synth. --Six words (talk) 14:58, 3 December 2011 (UTC)

No, that is precisely a synthesis! It is exactly what WP:SYNTH prohibits us from doing. You can sometimes get away with a simple synthesis when the result is non-controversial - but this is highly controversial. You simply aren't allowed to rely on your own "common sense" - because that may be flawed. In this specific case, you may be correct that "the effects of homeopathic interventions cannot be distinguished from that of placebo" - but the medical "effect" is not the entire problem. For example: the cost of homeopathic treatments to (for example) the NHS or an HMO, is vastly higher than that of placebo (compare $14 for 2cc's of "homeopathic eye drops versus $5 for a gallon of saline). So I (personally) consider it highly unethical to prescribe a homeopathic medicine rather than a placebo because that results in a higher charge to the NHS/HMO. The result of doing such an irresponsible thing is that there is less money available to provide valuable medicines to people who really need them - and that is unethical.

Now - you may argue about whether my position is valid or not (I'm sure you will) - but that's 100% not the point here. The point is that my objection shows that this synthesis is indeed controversial. Just like any controversial fact, you need a solid reference before you can add it to the article - and you don't have one. Tying together these two disparate WP:RS's together does not constitute a solid reference for the claimed fact because it's a synthesis - and an inadequate one at that. In this case, your "common sense" is demonstrably fallible - and that's why Wikipedia requires a single, direct reference for any controversial fact. SteveBaker (talk) 15:13, 3 December 2011 (UTC)

I really think this entire issue just boils down to the fact that Homeopathy can have a placebo effect (just like anything can, if the individual believes the "remedy" will have an impact.) Granted, homeopathy has no active ingredients so there are no side effects (other than a possible nocebo effect. But, the same can be said for Reiki healing and many other pseudoscientific procedures/medications. If there's evidence that the placebo effect of homeopathic concoctions are especially strong, then that should be referenced and included. Otherwise, I don't see how any of this pertains specifically to homeopathy; it (potentially) belongs on the placebo page, not here.JoelWhy (talk) 21:35, 22 November 2011 (UTC)

That's certainly true. Homeopathists (and homeopathy apologists) are desperate to have any shred of evidence that what they are doing is good/valuable/effective - and the placebo effect seems to give them that. The trouble is that water or sugar pills or herbal medicine or witch doctoring or shiatzu massage or pads you stick on the soles of your feet or holding pyramids over the patient's hand...or anything that is dispensed convincingly enough...has the exact same effect on gullible patients. Attributing this to something notable about homeopathy is, at best, misleading.

Taking a document that asserts that X has some property Y - and tying that to another document that says that Z is really a kind of X - and then drawing the conclusion that Z has the property Y is WP:SYNTH - and it's not allowed. For any kind of controversial (or potentially controversial) statement, we need a single reference that says directly that Z has the property Y...and in this case, since this is a medical topic, that RS has to pass WP:MEDRS.

In this specific case, we have one or more WP:RS that say that "placebo" (X) has the property "can be prescribed ethically" (Y). We also have multiple references that say that "homeopathy" (Z) is a kind of "placebo" (X). Then we have this effort from Sleuth21 to make a statement to the effect that "homeopathy" (Z) has the property "can be prescribed ethically" (Y). Sadly, as this analysis clearly shows, that is a case of WP:SYNTH writ large.

I'll admit that you can sometimes get away with a mild case of uncontroversial synthesis in an article - just as you can get away with making uncontroversial statements without reliable sources. If you have one RS that says that one particular car (Car 'A') can go 120mph and another RS that says that Car 'B' can go 150mph - then you're probably going to get away with saying "Car B is faster than Car A" - citing both references - without someone calling you out on grounds of synthesis. Technically, that is a synthesis - but it's an incredibly non-controversial one. But that's not the situation here. Claiming that you can ethically prescribe homeopathic treatments is exceedingly controversial and demands the highest possible level of sourcing and non-synthesis.

I (personally) find this edit considerably controversial because I don't believe it's ethical to charge a healthcare provider $20 for a bunch of homeopathic pills when you know that you could just as effectively charge $1 for a bunch of orange tic-tacs placed into a regular medicine bottle. That means that this synthesis is highly controversial and therefore I (and a bunch of other people here) need a really solid, non-WP:SYNTH, reference for that statement.

So, if you can't find a reliable source (per WP:MEDRS) that says something more or less exactly like: "It is widely considered ethical to prescribe homeopathic treatments, even though the doctor knows that they work no better than placebo."...then you can't write this into the article. I don't believe such a statement exists - mostly because it's patently untrue! SteveBaker (talk) 22:37, 22 November 2011 (UTC)

Sleuth21's lead redesign

A very drafty 'Homeopathy Lead Re-Design' page is now visible on my user page's sandbox, still lacking most references (some existing ones are still faulty), annotations, and three or four additional sentences. Sleuth21 (talk) 06:54, 29 December 2011 (UTC)

That's here, by the way.

It doesn't do too much beyond stripping out most of the reference (these are not, technically, necessary in a lead as it should just summarise material that is referenced in the body of the article, but are there because sourcing for virtually every statement in the lead has been challenged - see the talk archives).

My observations on the draft as it is at present:

First paragraph - no changes from current version.

Second paragraph of current version - omitted. As I have previously said I am not convinced that this sentence is necessary in the lead anyway.

Third paragraph - minor changes to the sentence about the "law of similars" not being a true natural law, references to succussion omitted. The first is probably a slight improvement. The omitted references to succussion, though, need to be retained as this is stated to be an essential part of the potentization process.

Fourth paragraph - Some changes proposed. I'm not sure what the word "text" in square brackets is supposed to indicate; what could usefully be added at this point? The omitted statement that "higher quality trials tend to report results that are less positive" is an important and well-sourced statement that needs to be retained.

Fifth paragraph - a comment about quantum mechanics added, and the last sentence amended. Not sure where you are going with the QM bit - if it is intended to apply to the comment about mechanisms for homoeopathy then it's already included in the previous sentence; if it is intended as a comment on QM then it belongs in an article about QM, not here (and QM is extremely well supported by experimentsl evidence, in any case). The wording omitted from the final sentence is adequately sourced, and (like pretty much every word of the current lead) included as a result of extensive discussion on this talk page - see the archives.

Sixth paragraph - passage about injected remedies omitted, specific examples of conventional treatments omitted. As for the first, I agree: injection of remedies is not a widespread enough in mainstream homoeopathic practice (I suspect that the vast majority of homoeopaths would have nothing to do with it) to be mentioned in the lead. the mention of vaccinations and antibiotics should be retained as these are specific treatments that homoeopaths frequently oppose, and the recommendation of homoeopathy in place of antimalarials deserves a place because of the high profile reports about this.

Seventh paragraph - no changes proposed.

I'm not convinced that there is a place in the lead for "The appeal of homeopathy and how doctors cope with it" There doesn't seem to be much on this in the body of the article (which the lead is, after all, supposed to summarise). Perhaps something about this could be included in the body of the article, possibly associated with the "prevalence" section?

To summarise: I agree with the omission of the second paragraph. I agree that the wording of the passage about the "law of similars" not being a natural law needs to be improved. I agree with the removal of the passage about injection of remedies. I don't think the rest of the changes have any merit in a lead that is the result of consensus arrived at after a great deal of discussion. The references currently in the lead should be retained. Brunton (talk) 12:18, 29 December 2011 (UTC)

First paragraph: "...preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient." Believed by whom?

Fourth paragraph -- I also don't understand the purpose of the QM reference. (I think I know what you're driving at, but it doesn't fit as written.)

Fifth paragraph -- Does homeopathy necessarily teach against the use of conventional meds? Granted, many homeopaths are likely critics of "Western" medicine; but, I'm not sure that it's an actually teaching within homeopathy (but, I could be wrong.)JoelWhy (talk) 19:54, 29 December 2011 (UTC)

Believed by homoeopaths. Unfortunately there is no more evidence that they actually do than there is for the rest of homoeopathy. See the "provings" section for information about how they decide what symptoms the remedies cause. Perhaps "claimed to cause..." would be better.

Fifth paragraph - see the "Ethics and safety" section, in particular the stuff about "suppression". Brunton (talk) 20:27, 29 December 2011 (UTC)

Homeopathy isn’t necessarily cheaper

Just a little anecdote: Homeopathy isn’t necessarily cheaper than real medicine. I stumbled upon a homeopathic motion sickness remedy that was more expensive than Gravol. — TheHerbalGerbil^(TALK|STALK), 14:26, 19 November 2011 (UTC)

Or just read this(!): CVS Leg Cramps Pain Relief Caplets quota (talk)

“ Active Ingredients: Cinchona Off. 3X HPUS; Viscum Alb. 3X HPUS; Gnaphalium Poly. 3X HPUS; Rhus Tox. 6X HPUS; Aconitum Nap. 6X HPUS; Ledum Pal. 6X HPUS; Magnesia Phos. 6X HPUS. Inactive Ingredients: Lactose NF, Microcrystalline Cellulose, and Vegetable Magnesium Stearate ”

Hmmm, the last time I checked, the FDA didn't consider 3X to be a homeopathic dilution. LeadSongDog come howl! 16:14, 28 November 2011 (UTC)

3X HPUS does not mean 'three times', it means ten-to-the-power-of-three-times. That is, one part in one thousand of the original solution (itself typically mostly water and/or alcohol) exists in the bottle one is expected to pay $5.79 for. So the original solution must have been worth $5,790 (OK, a bit less than that, allowing for the packaging).

6X HPUS is a one millionth solution. quota (talk)

That's correct, as explained at length in the article. The point is that some substances are sufficiently toxic that a 0.1% solution can still be hazardous. Accordingly the FDA regulations don't broadly exempt all such modest dilutions from the new drug approvals process the way they do ultramolecular dilutions (which can be safely considered inert). Indeed, their caution against use by people with quinine sensitivities points out the problem rather directly. This came into play with the Zicam case. That CVS product has another problem, it violates the regulatory requirement for English-language listings on the packaging in lieu of the no-longer authorized Latin. But in any case this is all off-topic. LeadSongDog come howl! 19:47, 28 November 2011 (UTC)

The stupidity of that ruling is that if something is unregulated then the dosage levels are also unregulated. If the instructions on the homeopathic treatment were to say that (for example) you should drink a liter a day of 3X (0.1%) dilution - then that's the same dose of active ingredient as 1cc of undiluted material. Plenty enough to kill you if it's a poison. SteveBaker (talk) 14:51, 3 December 2011 (UTC)

Rheumatology as source for psychological healing

I'm not happy with using this source, firstly because the sentence it's used for
“This caring engagement can prove particularly effective when conventional physicians have limited time with the patient or cannot provide a diagnosis or treatment.”
isn't in fact supported by the source as it's a single trial dealing with rheumatoid arthritis, so it's a massive exaggeration of the trial's weight to extend its conclusion - homeopathic consultations helped RA patients - to such a broad statement.
Secondly, it doesn't even discuss what shortcomings of conventional treatment might be to blame (for RA it's definitely not lack of diagnosis or treatment).
Finally because the study's limitations as pointed out by the authors (the study was underpowered, had a higher than expected drop out rate and the results are not yet replicated) make it unfit to draw definitive conclusions even for the condition it discusses. Like many small trials, it's a starting point with interesting findings, but there has to be a larger study to confirm its results. --Six words (talk) 12:33, 5 December 2011 (UTC)

Thank you, Six Words, for your comments and for correcting the format of the reference I added to the Homeopathy article. I am sorry that you are ‘not happy’ with using this source. I may have misled you by adding the reference to the study by Brien et al. in arguably the wrong place: it doesn’t really fit (as you rightly point out) in the ‘Psychological healing’ section with its several qualifications. I have therefore just added a further subsection ‘The therapeutic effect of the consultation’ to the WP Homeopathy list of possible 'Explanations of effect'. The details of the Brien study are added there, and those of an editorial comment by Professor(now emeritus) Edzard Ernst.

Your remaining points are not relevant. As an editor of a WP article I am under no obligation to analyse a study I wish to add, provided it is pertinent and from a reliable source. ‘Rheumatology’ is one of the core clinical journals in PubMed, all its research content is severely peer-reviewed, and the study protocol has of course passed the invigilation of several ethics committees.

If the paper fails to discuss aspects you feel it should have mentioned you have to take that up with the editor of Rheumatology or the authors of the article. As any good research paper it discusses its limitations which, the authors claim, do not invalidate their main findings. I do not have to re-analyse the statistical power of any of these findings – all the details are in the paper. The study is exceptionally well conducted and documented.

Nowhere in the study is it claimed that the authors have found 'definitive conclusions'. This is a small study which I can add to the article now – I don’t have to wait for a larger study to confirm (or otherwise) their carefully phrased and important findings. I think an extract from Edzard Ernst’s editorial (mentioned above) may clarify the position and my rationale for adding this study:

[…] I therefore suggest that we avoid unnecessary complications and take the results of Brien et al. […] at face value. Homeopathic remedies are ineffective and empathetic therapeutic encounters are helpful. So, we should discard the ineffective and adopt the helpful. If we do this, we must tell our patients that homeopathic remedies are both implausible and ineffective. Thus, they cannot be recommended. Of course, we should be equally clear that therapeutic relationships affect clinical outcomes.[…] The recognition of the therapeutic value of an empathetic consultation is by no means a new insight […], yet it is knowledge that is in danger of being forgotten. […] Clearly, this is wrong and may well be one reason why patients consult alternative medicine practitioners. […]

If I had a say in this matter I would strike out the whole of the confused and confusing Homeopathy article from WP and put Prof Ernst’s editorial in its place. That’ll be the day (also for WP)! Reinhard Wentz (sleuth21) Sleuth21 (talk) 05:13, 8 December 2011 (UTC)

Actually Sleuth21, you need to review WP:MEDRS. We do have an obligation to determine the quality of a citation, and that it is a primary study that hasn't been reviewed makes it weak at best, and useless. Moreover, to synthesize your own conclusion from an unrelated source is disingenuous. OrangeMarlin ^{Talk• Contributions} 05:34, 8 December 2011 (UTC)

Recent Revert

I recently reverted an edit adding content to "Explanation of effects". Per that editor's suggestion, I'd like to bring the issue here for discussion. As far as I can tell, that section is devoted to explaining the effects of homeopathy according to the scientific literature. However, this new edit appears to introduce content discussing how CAM is used in oncology. This doesn't appear to be relevant to the section, or the particular bullet point to which it's being added. I don't necessarily see a problem with adding the content elsewhere, if it's appropriate, but it seems out of place in this particular section at least. Can another editor look the content over and weigh in? Thanks.   — Jess· Δ♥

Thanks. I will now wait and see what other editors say and then come back.Sleuth21 (talk) 18:54, 9 December 2011 (UTC)

I don't even see the word "homeopathy" mentioned in the abstract. So, unless there is something in the full article that specifically addresses homeopathy, it absolutely does not belong on this page. (If the article does mention homeopathy, I would need to review in closer detail to decide whether I personally believe it should be included.)JoelWhy (talk) 18:42, 9 December 2011 (UTC)

This citation seems to fail WP:MEDRS on its most basic level. It does not appear to mention homeopathy, so it's a form of synthesis to relate what the authors conclude (which I find fairly silly, and would argue that the article fails MEDRS anyways) to homeopathy. I think we need to move on. OrangeMarlin ^{Talk• Contributions} 20:53, 9 December 2011 (UTC)

Yes, I agree, let’s move on. But before we do: just a small note. The section ‘Explanation of effects’ in the Homeopathy article is (as of this moment) supported by 18 references, only four of which (all put there by me) mention homeopathy in the title or the body of the article. None of the others do. Should we not delete them too? If not, why not? I know the answer, and wouldn’t want to delete them, but do you, Orangemarlin? Should we not reinstate my last edit; its reference mentions homeopathy in the body of the paper. BTW: the first reference in that section is dead, the penultimate is a lazy one: it doesn't point directly at the relevant definiton of 'meta-analysis' from the glossary of the Cochrane Collaboration, as I should know... Now let's move on! Sleuth21 (talk) 23:45, 9 December 2011 (UTC)

Goodness, I just noticed that Orangemarlin told another WP editor to 'stay the [expletive deleted] off his page'. Time not just to move on but to stayoff this WP article altogether.Sleuth21 (talk) 00:04, 10 December 2011 (UTC)

Sleuth21...I do not say that to everyone. My basic rule is that article discussions stay on the article talk page. My talk page is to be used for discussing baseball. Bitching about the overall uselessness of admins (unless I like them) and Arbcom (unless it's a member I like). You have done nothing to annoy me, and I would hope that you have thick skin nevertheless. I doubt you would receive a "stay the fuck off my page" commentary. Anyways, now that you brought it up, I guess we better review your 18 citations. Really, we shouldn't extrapolate a conclusion when the cites don't support it. OrangeMarlin ^{Talk• Contributions} 04:57, 10 December 2011 (UTC)

Sleuth, the answer is simple: the section is sourced with Jay W. Shelton - Homeopathy: How It Really Works, and this is the source connects the “science part” with the “homeopathy part”. It is of course not a copy&paste of Sheltons list, as that would be a copyright violation. The additional sources (used to explain p-value and publication bias) aren't used to make statements about homeopathy, but about medical trials in general, and while I (still) think that those explanations aren't easily understandable to the 'average reader', the sources themselves are fine. Our sourcing rules are pretty simple: Use WP:MEDRS for medical claims and WP:RS for everything else (unless it is so trivial that it is uncontroversial, in which case there's no need to cite a source), and don't combine sources to reach a conclusion unless there's already a source that has made that connection for you (you'd obviously cite this one source then instead of the two unconnected ones). While reporting bias and p-value aren't part of Shelton's bulleted list (IIRC - don't have access to a copy right now), he discusses them in the book, so including them isn't WP:SYNTH, they can be sourced with Sheldon as well; we could definitely lose some of the sources explaining p-value and publishing bias though as we don't need five to six sources for single sentences.
The last point (“meta-analysis”) doesn't really belong in that list as it's not an explanation of what may lead you to think something inert is effective. --Six words (talk) 12:13, 10 December 2011 (UTC)

Lead section

Hi, I think one of the aims of the lead section should be to give people a quick explanation of the key things they want/need to know, even if they decide to read no further. I find "...that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient" in the very first sentence confusing. Why would this be a desirable property? What relevance does it have to treating patients? Is it somehow connected to "law of similars" and "let like be cured by like"? Next, the sentence starting "In the context of homeopathy, the term remedy is used to refer to ..." tells me "not to be confused", but leaves me more confused than if the whole sentence had been omitted. In these and various other ways, I think the lead section is rather poor. I am not asking to be directed to some part of the article that explains something in more detail, and I am not seeking explanations here on the talk page. I am suggesting that the lead section could and should be improved. 86.148.155.39 (talk) 03:13, 10 December 2011 (UTC)

That is a plain (or as plain as we have managed without becoming inaccurate) language description of what homoeopathy is. It actually does claim to treat disease using preparations that are claimed, in a healthy subject, to cause similar symptoms to those exhibited by the patient. Whether this is "a desirable property" or relevant to treating patients is beside the point - it's just what homoeopathy is. For more discussion of this, see the section of the article relating to remedies, in particular the subsection about "provings", and see the talk archives - the lead of this article is the result of consensus arrived at after many extensive discussions. Personally, I'm not convinced that the "In the context of homeopathy, the term remedy is used to refer to ..." section is needed in the lead as long as it is made clear in the body of the article, but consensus was against me on this.

If you don't want "to be directed to some part of the article that explains something in more detail" (the lead is supposed to summarise the parts of the article that explain things in more detail), and don't want explanations of why it is the way it is, do you have a better suggestion for the wording you are objecting to? At the moment you haven't provided anything for discussion. Brunton (talk) 11:45, 10 December 2011 (UTC)

Thanks for your interest. A start would be:

(1) Clarify the following paragraph, and/or move it somewhere less prominent, or just delete it, depending on what it is supposed to mean:

"In the context of homeopathy, the term remedy is used to refer to a substance which has been prepared with a particular procedure and intended for patient use; it is not to be confused with the generally accepted use of the word, which means "a medicine or therapy that cures disease or relieves pain"."

This confuses the heck out of me. It is making a distinction between "cure disease or relieve pain" and what homeopathy claims to do? Or is it saying that the claims are false and the "remedies" do not actually work? At first I thought it meant the former, but now I'm thinking it may be the latter, in which case it should be just deleted as (at this stage) unnecessary repetition couched in confusing wording. If it's important to introduce the technical term "remedy", then it can go here, in the first paragraph:

...claim to treat patients using highly diluted[2][3] preparations, called remedies, ...

(2) Add "The basic principle of homeopathy, an unproven assertion known as the "law of similars", is "let like be cured by like."

and delete oddly worded and over-laboured explanation:

"His "law of similars" is taken on his word[8] as an unproven assertion, and is not a true law of nature based on the scientific method."

(3) The "basic principle" is stated to be "let like be cured by like". However, even before this is the "believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient" stuff. Is this an even more basic principle? How do the two things relate? I have no expertise in this area and cannot offer a proposed wording. All I can do is tell you that it is not currently clear. 86.179.7.53 (talk) 23:15, 19 December 2011 (UTC)

(1) I agree. I personally would have no objection to this sentence being removed from the lead, partly for reasons of brevity.

(2) The expression originally used was "ipse dixit axiom" (with the links) but this was deemed not to be plain enough language and replaced with "taken on his word as an unproven assertion..." I think your suggestion is an improvement on the current wording.

(3) "treat[ing] patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient" is a basic and (reasonably) plain English description of what homoeopathy is (as is appropriate for the first sentence of the lead), incorporating both the "law of similars" and the dilutions. The "law of similars", which is the basic principle underlying this, is then introduced in the third paragraph - what application of this "law" involves is treating patients using preparations alleged to cause the symptoms they are suffering from if given to healthy subjects.

The second paragraph could probably be dropped from the lead and just left in the "Remedies" section of the article, and the start of the third paragraph could probably do with tidying up. The opening paragraph should be left pretty much as it is unless we can come up with a more concise expression of the same thing. Brunton (talk) 00:24, 21 December 2011 (UTC)

The above seems to incorporate some misunderstandings.

(1) Clarified the misleading term "remedy" to make it clear that the voice of the encyclopedia is not asserting that water is really a remedy for anything but thirst, irrespective of what homeopaths may say.

(2) Avoiding the latinism is an improvement, but the repetition is somewhat inelegant. Perhaps "The "law of similars" is evidenced only by his unsupported word[8]. It is not a law of nature evidenced by application of the scientific method."

(3) Misconstrues the "proving". The healthy subjects are given substantial doses, not homeopathic ones, to establish what they are "like". LeadSongDog come howl! 04:08, 21 December 2011 (UTC)

(1) I agree that this needs to be somewhere in the article, but it's too detailed for an already long lead, which already states in the opening paragraph that homoeopathy doesn't work.

(2) I think describing it as an unsupported assertion is sufficient for the lead. We should be aiming for as much brevity as possible in the lead.

(3) No, "provings" pretty much invariably seem to involve giving the subjects the diluted remedies, as prescribed back in the 19th century by Hahnemann (see the Organon, 5th or 6th ed, aphorism 128), not substantial doses. See the reference given in the section of the article about provings, or any of the reports of "provings" that homoeopaths have posted on the internet. The "law of similars", Hahnemann's original idea, says nothing about the dilution somehow reversing the effect; it simply states that disease can be treated by a remedy that would produce similar symptoms in a healthy subject. Hahnemann initially used substantial doses both for provings and for treating patients. The dilutions were a later idea of Hahnemann's which he believed would both intensify the curative effects and reduce unwanted effects (as with most things that appear too good to be true, this is too good to be true), and after deciding that patients ought to be treated with diluted remedies he also moved to "proving" the same diluted remedies. Brunton (talk) 10:40, 21 December 2011 (UTC)

Skeptoid Reference

I see that a Skeptoid episode was referenced, removed, referenced again, and then removed again. Why was it removed? Seems relative and notable. JoelWhy (talk) 13:34, 13 December 2011 (UTC)

It was added to (and removed from) a lot of articles. There's a broader discussion here. bobrayner (talk) 13:42, 13 December 2011 (UTC)

Ahh, thanks. I'll post there.JoelWhy (talk) 13:48, 13 December 2011 (UTC)

Hahnemann a nutter?

A recent addition to the lead "...who said that the idea of homeopathy arose from a series of illuminations he had received during spiritualist séances " is anachronistic and should be deleted. A catholic blog specialising in debunking magic, idolatry, and other spiritual threats to catholic souls is not acceptable as WP:RS. Homeopathy has no basis in modern science, but to denounce Hahnemann in terms which make him (to 21st century readers) look a nutter and weirdo is not acceptable. Many leading thinkers of the 18th and early 19th century in Europe were ‘spiritualists’ in one sense or another and therefore, incidentally, posed a threat to the catholic church). I intend to delete the text and reference from the lead. Sleuth21 (talk) 21:13, 22 December 2011 (UTC)

I do have a problem with the source, but if there was a good source for the information, I'm not sure I agree that the information shouldn't be added. If the point is that the entire genesis of homeopathy was based upon a guy who learned of this "magic" through ghosts (or whatever), and the current practices are based upon this guy's teachings, I would say it's definitely relevant. Or, am I missing something here?JoelWhy (talk) 21:56, 22 December 2011 (UTC)

You are indeed. Hahnemann was, in no sense whatever, merely a guy who learned of this "magic" through ghosts (or whatever). Homeopathy is profoundly unscientific to modern eyes, but Hahenmann was not some guy (in the derogative sense you use that term). Neither were Newton, Leipniz, Goethe, Voltaire, or Lessing. They all believed, partly, in what we would see today as unscientific notions. You aren't quite so ignorant as you seem to pretend, JoelWhy. Reinhard Wentz Sleuth21 (talk) 23:04, 22 December 2011 (UTC)

The source is very poor, and the alternative sources that I have found were generally of a similarly poor quality. There were some that looked slightly better but made a slightly different claim: That Hahnemann was influenced by Mesmer and Mesmerism. But even for that I found denial by homeopaths. What we need here is a scholarly source, not random sources that may be copying a misconception. Popular sources tend to copy from each other, and when they like something, they tend to add a little bit in their own version. Over several iterations a vague comparison or a clearly speculative comment can turn into certain knowledge.

Occultism and spiritism weren't so unusual at the time, or Mesmer would hardly have had the huge success that he did have. Hahnemann lived much closer to Newton than to us, and our article on Isaac Newton's occult studies gives some perspective. The real problem is not that Hahnemann was interested (if he was interested) in such things at a time when much of the world was still unexplained. The real problem is that homeopathy follows the logic of a religion rather than that of a science. Hans Adler 22:40, 22 December 2011 (UTC)

If the sources are bad, then I agree, there's no place for it. If, however, there's good evidence that he "...said that the idea of homeopathy arose from a series of illuminations he had received during spiritualist séances," the fact that those were different times is irrelevant; it should be included (perhaps with a mention that such beliefs were the norm at the time, etc.) It doesn't necessarily belong in the lead, but it would deserve mention.

Suppose we learned that Darwin's idea regarding evolution stemmed from his claim that he was visited by the ghosts of a dinosaur. It doesn't invalidate his theory; but, it's certainly something we would include in his Wiki page -- not to cast doubt on the Theory of Evolution, but because it would be relevant to the article.

Of course, the situation here is a bit different. The origins or homeopathy (if this is accurate) do at least raise an eyebrow or two. But, in addition to being of relevant historical fact, it highlights the fact that, unlike science, which changes based upon new discoveries, here is a practice/belief that has remained relatively stagnant since its inception, irregardless of the evidence (or lack thereof.)

That being said, the discussion is moot unless there's a good source.JoelWhy (talk) 22:49, 22 December 2011 (UTC)

The suppositions of some people or the positions of their eyebrows are irrelevant to the argument. You raised a moot point, I merely questioned the reliability of the reference and the relevance of the wording in the lead, JoelWhy. I will delete the text and the reference. Sleuth21 (talk) 23:16, 22 December 2011 (UTC)

If (and only if) it can be adequately sourced it probably belongs in the body of the article (under "Hahnemann's concept" in the "History" section), but it doesn't belong in the lead (cf. the Ouroboros reverie being mentioned in the articles for Kekulé and benzene). Brunton (talk) 09:56, 23 December 2011 (UTC)

Homeopathy as Religion?

WP:NOTFORUM Bulwersator (talk) 13:32, 27 December 2011 (UTC)

Hans Adler rightly points out towards the end of the previous thread: The real problem is that homeopathy follows the logic of a religion rather than that of a science. That is true, but also applies to Ayurvedic or Traditional Chinese Medicine. Both get fair and dispassionate entries in their respective Wikipedia articles, especially in the lead sections. Homeopathy does not. It is instead vilified relentlessly in an act of self-loathing by a group of Wikipedia editors praying at the temple of the ‘Homeopathy is evil’ church. This well established sect with its high-priests, willing followers and other religious accoutrements cannot accept that there is possibly anything good about the ideas or the history of Homeopathy. They extend the vilification of course to Hahnemann and to any poor editor who dares to suggest that there doesn’t have to be a conflict between science (The effects of homeopathic ‘remedies’ are not distinguishable from placebo) and the idea that homeopathy is an important part of our cultural heritage, just as Ayurveda or TCM. As the man said in the BMJ in 2001: [1] 'Regular medicine is anchored in science and factuality, alternative healing methods are part of cultural constructs and (often) religious belief systems and provide meaning and morality, but cannot be pitched against regular, scientific medicine. It could be argued that homeopathy, ayurveda, traditional Chinese medicine and other healing systems have a higher degree of truth, that they may offer more sustainable remedies for wounds of the heart or of the soul (provided the patients and the healer share the same value system) but their tenets are not generalisable and are not anchored in science. The two areas of experience do not overlap in the external world (see e.g. Gould 2001+), but are integrated only in the heart and mind of the individual doctor and her patient. The growth of alternative 'medicine' in developed countries can be partly explained by the fact that any sufferer choosing alternative therapies knows that the proven remedies of regular medicine remain available to them if something 'goes wrong' or 'does not work'. This is particularly true in the UK, where access to regular medicine is free. As a mere thought, not a practical suggestion: should users of alternative healing methods in this country be told that by so choosing they exclude themselves from access to regular medicine?' Should the above mentioned Wikipedia sect perhaps get a mention in an updated version of E Ernst's article The public's enthusiasm for complementary and alternative medicine amounts to a critique of mainstream medicine’’? PMID 20846193 +Gould, S. J.: Rocks of ages. Science and religion in the fulness of life. London: 2001. passim Sleuth21 (talk) 18:18, 23 December 2011 (UTC) Homeopathy gets fair treatment according to Wikipedia policy, reliably sourced information and the facts. The passage you quote from "the man" (actually a personal comment from the BMJ's "rapid responses"), which described homoeopathy as "not anchored in science", does nothing to establish any "unfairness" in this article. What should, or should not, get a mention in Edzard Ernst's articles is a matter for him, not for this talk page. Do you have any actual suggestions for improving the article? It is a little hard to see how characterising the rest of the editors here as "self loathing" or "a group of Wikipedia editors praying at the temple of the ‘Homeopathy is evil’ church" is going to accomplish this. Brunton (talk) 12:54, 24 December 2011 (UTC) It is precisely because both articles are fair and accurate that they differ so markedly. The Ayurveda article spends considerable numbers of words on the discussion of available studies on this form of medicine (with references) - however, there just aren't that many high quality studies done on the subject (which is amazing when you consider the vast number of people who use this as their sole form of healthcare). Homeopathy has been much better studied. What is clear is that at least some of the Ayurveda treatments do actually work better than placebo. Many other treatments that it recommends are either ineffective or downright toxic - and our article explains that quite clearly. Moreover, it's not obviously true (in light of modern science) that traditional medicines are ineffective - they use many chemically complex ingredients - some of which are known to have highly active chemical effects in the human body. It's very possible that at least some of their treatments do actually work. Example: I recall as a kid in England being told by parents, friends, etc that if you got stung by brushing up against a stinging nettle that rubbing the leaf of a Rumex obtusifolius (a "Dock leaf") onto the skin would cure it. It turns out that this common folk treatment actually works very well - and modern science has discovered that this is because those leaves contain an astringent and that their texture is uniquely suited to pulling the tiny stinging hairs (trichomes) out of the skin. Dock leaves are a better cure (with no side-effects) compared to antihistamines or hydrocortisone creams that are the best that modern medicine can provide in this case. By happy coincidence, the Dock and the Stinging nettle are often found growing in the same habitat. Immediate treatment is required to alleviate the pain of the sting - so grabbing a handy Dock leaf is the by far the best treatment. So some traditional medicines work - and work very well. Not all...perhaps not many...but at least some of them do. With homeopathy, we know that there is no active ingredient whatever in the treatment - and (unsurprisingly) no properly conducted studies have ever shown a solid benefit to them (beyond that of placebo). Conclusion: Science says: Homeopathy is a hokey idea that can't work in theory and (unsurprisingly) has been proven not to work in practice. Ayurveda is a bunch of different ideas - some hokey, some not so stupid - but many of it's ideas (eg traditional herbal treatments) can certainly work in theory and sometimes do work in practice. That's what these two articles say. I see no problem with that. SteveBaker (talk) 15:04, 24 December 2011 (UTC) This is in not completely true. I think you are exaggerating here. Please read : "There is also evidence from randomized, controlled trials that homeopathy may be effective for the treatment of influenza, allergies, postoperative ileus, and childhood diarrhea". It is a good source of information. --OBenfey (talk) 04:35, 26 December 2011 (UTC) "May be effective"? Hardly an unequivocal positive. And it's always worth reading the article as well as the abstract, if you have it. The article's conclusions section, for example, does not seem as positive as the passage you quote from the abstract ("some randomized, placebo-controlled trials and laboratory research report unexpected effects of homeopathic medicines. However, the evidence on the effectiveness of homeopathy for specific clinical conditions is scant, is of uneven quality, and is generally poorer quality than research done in allopathic medicine. More and better research is needed, unobstructed by belief or disbelief in the system"), and while the abstract says that there is evidence from RCTs that homeopathy "may be effective" for postoperative ileus, the article itself says "In several other conditions, most notably postoperative ileus (44), asthma (45), and arthritis (46), the evidence from controlled trials is inconclusive". As for the comment about allergies, note that the article cites a comparatively small positive study of homeopathy for allergic rhinitis, but then says that a "larger study using a similar protocol did not reproduce this clinical effect", and note this comment about the statistics in the positive study. They also cite a 1996 meta-analysis of a homeopathic remedy for allergic rhinitis. I can't find the exact paper on pubmed (I can only find hits for the journal it is in from 1998 onwards), but there's one with the same authors and title from another journal in 1997 (article is in German, perhaps a republication of the same analysis?), which while it appears positive, the abstract of which concludes with the caveat "As not all of the single studies were analyzed by intention to treat analysis the results may be biased." Brunton (talk) 09:20, 26 December 2011 (UTC) Yes, exactly. There are simply no trials that stand as clear proof of homeopathy working better than placebo. The few that have come out with mildly positive results have been disproved with subsequent larger trials or by correct re-analysis of the evidence collected. That being the case, by all modern medical standards, homeopathy doesn't work. Since our standards here at Wikipedia lay out how we must represent scientific research in the case of medical claims - our article is saying precisely the right thing. SteveBaker (talk) 14:25, 26 December 2011 (UTC) SteveBaker, until you appreciate that Medicine, to use the oldest cliché in the book, is an art based on science (or a science based on art) and not just cold, rational science (we all know were that can lead to), you will not understand the point of this thread. That homeopathic remedies don’t / can’t / will never work is beyond doubt. I am merely trying to identify studies which demonstrate that (in this context: homeopathic) consultation may have specific beneficial effects. Your frequent suggestions that this is ‘a clever ruse […] to duck out of Wikipedia's standards’, and equally frequent attempts to lump me together with ‘Homoeopathists (and homeopathy apologists) [who] are desperate to have any shred of evidence that what they are doing is good/valuable/effective’ is wrong and insulting. Not that you care. I would be astonished if you did. When I mention, in a different context, 'common sense' in its generic, pragmatic sense which stood science in good stead ever since Occam' sharpened his razor, you construe this to mean ‘your [i.e. my] own "common sense"’. These and similar ruses used with casual, malevolent intent by you throughout this thread are indicative of your desperation to prevent any sober discussion of the attraction of homeopathy. I hope that you keep counting the multitudes of hapless patients traipsing off to a homeopathic quack, wrongly assuming that they can’t get a sympathetic hearing from their 'regular' medical advisor. I note your fascinating anecdote of ayurvedic healing, which reminds me of anecdotal evidence that homeopathy, of course, works: ‘I don’t care about the cold statistical evidence, I know from what my patients tell me that it works’. Extremes touch, the snake bites its tail, Ouroboros! Enjoy the company of your fellow supporters of the ‘Homeopathy is Evil’ cult; you have a lot in common with the homoeopathists who believe in the memory of water, ‘quantum’ entanglement, or other scientific nonsense. Do shake hands. Wikipedia does not exist in isolation; it has an obligation (I thought) to provide encyclopaedic, current, and valid content. The suggestion that regular medical encounters often lack compassion is important; so are findings from studies which identify elements in homeopathic encounters which provide that solace. These are important findings supported by a growing number of robust primary, secondary, and tertiary studies. That all medical consultations have beneficial effects merely as part of the consultation may be a truism; the point is to discover more about which specific elements account for those effects. Sleuth21 (talk) 19:48, 26 December 2011 (UTC) Do you have any actual suggestions for improving the article? That is the sole purpose of this talk page. See WP:TALK, WP:SOAP and WP:POINT. Thank you for reiterating the question about improvements to the article. A draft outline of the lead for the Homeopathy article will appear soon in my Talk sandbox. I will outline the rationale for some aspects of the redesign here or on my Talk page. Sleuth21 (talk) 21:34, 26 December 2011 (UTC) I reiterated it because you had failed to address it, or to take any account of it, with your subsequent post. Brunton (talk) 22:06, 26 December 2011 (UTC) It is hard to see how characterising editors here as "supporters of the ‘Homeopathy is Evil’ cult" is going to accomplish anything. Brunton (talk) 20:06, 26 December 2011 (UTC) Hard, but surely not impossible? I merely don't want to argue all the time that I am not homoeopathist, an apologist of homeopathy, or live in a state of complete ignorance of WP rules and guidelines. Or perhaps I just haven’t got the thick skin of regular WP editor? Is this note also in violation of WP:TALK, WP:SOAP and WP:POINT? Sleuth21 (talk) 21:34, 26 December 2011 (UTC) Pretty much impossible, I suppose; I was using a figure of speech. You don't need to argue about whether or not you are a homoeopath, or whatever. What is appropriate on this talk page is discussion of how the article can be improved. You certainly don't need to ascribe viewpoints to other editors. Brunton (talk) 22:06, 26 December 2011 (UTC) Brunton, in answer to your question, no, Sleuth clearly has no suggestions for actually improving the article. Rather, he wants to decry his persecution, and the persecution of homeopathy, at the hands of us evil editors. Well, it's noted Sleuth. Now, can we move on with actually working on the article?JoelWhy (talk) 13:23, 27 December 2011 (UTC)

Sole effect

Besides being poorly sourced (it's still a single, underpowered, unreplicated trial), this could be said for any consultation - it's not the consultation that heals a severe bacterial infection, it's the antibiotics the physician prescribes (though the way the consultation goes can help the patient feel better). The source discusses a specific ailment (rheumathoid arthritis) so the most we could do is use it to say 'it has been suggested that this is the sole effect of the homeopathic treatment of RA', but we can't even do that since the authors tell us “A further study, powered to identify consultation effects, is needed to confirm the benefit of homeopathic consultations in this population.” --Six words (talk) 11:46, 24 December 2011 (UTC)

The consultation is what provides the placebo effect - placebos work if the practitioner promotes them as a cure. Any convincingly optimistic consultation might well do more than just make the patient feel better - it can have a material effect on the process of the condition. There is no proof that a homeopathic consultation is any more effective than a consultation that ultimately results in a placebo being given. 15:16, 26 December 2011 (UTC)

Homeopathy as a religion ?

I don't think that Homeopathy is a unified medical or philosophical movement or religion. The composition of its practitioners varies : from Mds to nurses and more. It is completely inaccurate to try to categorize such a diverse body of practitioners as a religion. --OBenfey (talk) 04:41, 26 December 2011 (UTC)

The fact that its adherents are members of different professions doesn't disqualify it from being a religion - I'm sure that there are both MDs and nurses (and, as with practitioners of homoeopathy, people without medical qualifications) who are Christians, for example. Brunton (talk) 09:35, 26 December 2011 (UTC)

I agree that practitioners being of different professions doesn't disqualify homeopathy as a religion. But almost everything it says in the lede of our Religion article does disqualify it. The first sentence, for example: "Religion is a collection of cultural systems, belief systems, and worldviews that establishes symbols that relate humanity to spirituality and, sometimes, to moral values." Homeopathy isn't a "world view" or a "cultural system" - it is essentially the claim of a two scientific "facts" - that dilutions of materials make them more "powerful" and that something that would normally cause some kind of medical effect can cure those same symptoms at very low concentrations. That's hardly a "worldview" - it says nothing about the origin of the universe or of life - it doesn't discuss morality or whether there is an after-life. It's a one-off, one-shot theory about medicine. It doesn't even demand faith - the claims it makes for cures are supposedly backed up by experiments. Worse still, if it were a religion, why would people who profess to belong to other religions also be a part of this one? One overriding feature of religion is that it is an exclusive matter. One cannot simultaneously be a Catholic and a practicing Islamist. How could one also be a Catholic and a Homeopathist if the latter were a complete religion with a complete worldview.

What homeopathy is can be best described by the term "pseudo-science" - a claim or theory that's couched in scientific terms yet which doesn't follow the scientific method of hypothesis/experiment/publication...and that's what our article says.

I am concerned that the effort to claim "religious status" for homeopathy here at Wikipedia is a clever ruse to enable the adherents of this bizarre pseudoscience to duck out of Wikipedia's standards for WP:MEDRS and WP:FRINGE. Articles on religion are frequently given a free ride through the bastions of logic and reason - which would suit homeopathists goals just wonderfully. At any rate, this claim does not seem to be backed by reliable sources - and until/unless it is, it may safely be ignored. SteveBaker (talk) 14:42, 26 December 2011 (UTC)

When a section on the religious nature of homoeopathy was proposed about three years back it was strongly opposed (not least by some of the proponents of homoeopathy) and led to the editor proposing it being given a seven day topic ban.

Homoeopathy is held out as a system of medicine, and it should be assessed on that basis.

That is not necessarily to say that there shouldn't be some mention of the religious aspects of homoeopathy, of course. A couple of articles about links between homoeopathy and religion can be found here and here. Brunton (talk) 20:31, 26 December 2011 (UTC)

• There are numerous sources which describe the influence of the philosophical/mystical/religious ideas of Emanuel Swedenborg upon the development of homeopathy. Our article seems to say nothing at all of this. Warden (talk) 23:12, 26 December 2011 (UTC)

Suggestion to improve the article : be more neutral

I think the most important issue here is neutrality : the prevailing view in the article is what stevebaker writes above : Science says: Homeopathy is a hokey idea that can't work in theory and (unsurprisingly) has been proven not to work in practice. I just presented another scientific view which differs according to the authors. Annals of Internal Medicine [http://www.annals.org/content/138/5/393.full Do Ultra-High Dilutions Produce Effects in the Laboratory?

Clinical trials are less sensitive for determining whether ultra-high dilutions have specific effects than laboratory research, where more rigorously controlled conditions are possible. The publication of laboratory investigations of ultra-high dilutions has produced considerable controversy and mixed results on attempted replication (52-54). Still, unusual effects of ultra-high dilutions in rigorous laboratory studies continue to be reported (55-59). Multiple independent replications of this research have not yet been done because there are few investigators in the field (60). Future research should focus on simple clinical or laboratory models that can be easily attempted by multiple investigators. In addition, better data are needed to examine the use and effects of homeopathy by the public and in actual practice (5, 29, 61). Conclusions Homeopathy is an alternative therapeutic system based on the “Principle of Similars” and the use of “minimum” doses. Homeopathy was a prominent component of 19th-century health care and recently has undergone a revival in the United States and around the world. Despite skepticism about the plausibility of homeopathy, some randomized, placebo-controlled trials and laboratory research report unexpected effects of homeopathic medicines. However, the evidence on the effectiveness of homeopathy for specific clinical conditions is scant, is of uneven quality, and is generally poorer quality than research done in allopathic medicine (61). More and better research is needed, unobstructed by belief or disbelief in the system (62). Until homeopathy is better understood, it is important that physicians be open-minded about homeopathy's possible value and maintain communication with patients who use it. As in all of medicine, physicians must know how to prevent patients from abandoning effective therapy for serious diseases and when to permit safe therapies even if only for their nonspecific value.]

Obviously, these authors hold different views from SteveBaker and from the current article on Homeopathy. Trying to incorporate them into the article would be a good step towards neutrality. --OBenfey (talk) 22:59, 26 December 2011 (UTC)

I can see OBenfey’s point but inclusion of this study would not be a good step towards neutrality of the Homeopathy article as there is no possibility of homeopathic remedies ever demonstrating as having any value. Q9 in the FAQ section of this WP article is quite clear about this:

Should the article mention that homeopathy might work by some as-yet undiscovered mechanism?’ and correctly answers No

However (and this neatly summarises the dilemma of discussing the effects of homeopathic interventions) in the last two sentences of the paper (they are not conclusions but a sudden, spontaneous statement, reflecting the compassionate nature of medicine as a combination of science and art) the authors say:

As in all of [the authors misguidedly use the expression ‘allopathic’] medicine, physicians must know how to prevent patients from abandoning effective therapy for serious diseases and when to permit safe therapies even if only for their nonspecific value.

These sentences imply that modern, humane, regular, ‘allopathic’ doctors must not abandon patients even if they, the patients, believe in nonsense.

On re-reading thes comments I don't feel too happy when referring to ‘Q9 in the FAQ section’. It looks as if I am quoting an article of faith. I’d much rather refer to the scientific consensus .... Reinhard Wentz Sleuth21 (talk) 03:07, 27 December 2011 (UTC)

According to the Neutral Point of View editors should include all notable views appearing in good reliable sources. The questions -you are referring to- are written by the editors of this page and they are not in line with the Neutral Point of View mode of editing. We should not care about personal opinions but on information found in reliable sources. I m really surprised that someone argues against inclusion of different point of views on a really controversial issue which are appearing in such good sources. Are you sure you are familiar with wikipedia's Neutral Point of View ? --OBenfey (talk) 04:26, 27 December 2011 (UTC)

The very long discussions in the gestation of this article means that anyone who has looked/contributed to this article is fully conversant with NPV.

You hit the nail on the head when you quoted that all notable views should be included. That a homeopath writes an article in support of homeopathy is not notable. Also, there is little controversy. From hundreds of published clinical trials, very few appear in scientific publications, most are found in alt-med/homeopath journals. After over 200 years homeopathy cannot show a predominance of positive clinical trials and no in-vitro experiments have been able to reproducibly detect any activity in preparations which have been as highly diluted as those recommended by homeopaths. In the article you cite, one of the authors is not only not a scientist but known to be anti-science and another has retracted much of his support for homeopathy. IMHO this article fails NPV recommendations. Acleron (talk) 06:40, 27 December 2011 (UTC)

Annals of Internal Medicine. The article certanly qualifies if we use wikipedia's criteria: It is a peer reviewed article published in a high impact journal (not in a homeopaths journal ) and there are other studies from the same authors which are cited in the current article in wikipedia . From what I read, the article is written in 2003. Who retracted what? Please do not tell me about your personal views on Homeopathy and do read more carefully. --OBenfey (talk) 06:59, 27 December 2011 (UTC)

I think we should tread slightly more carefully here. This area has indeed been gone over many, many times before in the genesis of this WP:article. One of the authors (Kaptchuk) of the study OBenfey mentions was a colleague of Edzard Ernst at the University of the Peninsula, Exeter (not so called then). He published two papers with Ernst during his time at Exeter, one of which is cited in the WP:article (currently ref. 213) . Ernst authored a paper in the British Homeopathic Journal (Vol. 87, 1998, pp 28-32, available online since 2006) which quotes that Ernst & Kapchuck paper, agreeing with it. I quote the abstract:

Criticism of homoeopathy started in Germany as soon as this new form of medicine became widely known-and has not stopped since. Early criticism came from non-homoeopaths and centred around the theme that homoeopathy's basic assumptions were not supported by demonstrable facts. Simultaneously, criticism from within homoeopathy attacked some of the rigid, dogmatic rules set out by Hahnemann. Today's opponents of homoeopathy argue predominantly that the efficacy of homoeopathic remedies beyond that of placebo has not been established. Polemic and emotive as this historical debate has been, much of it makes sense to the outside observer. Homoeopaths, it seems, would be well advised to take the reasoned elements of this criticism seriously. They might even attempt to turn seemingly unfair attacks into constructively working towards determining the truth.

This constructive approach towards a dialogue is reflected in several hundred substantial studies in the medical literature and should perhaps be mentioned not only in the body of our WP:article, but in its lead. Sleuth21 (talk) 08:58, 27 December 2011 (UTC)

Sleuth21, Q9 does not say what you think it does. It doesn't say that a mechanism will never be found; it says that the article shouldn't speculate about "some as-yet undiscovered mechanism". If a mechanism is established, it can be included. Brunton (talk) 10:48, 27 December 2011 (UTC)

The Annals of Internal Medicine paper is just another report of inconclusive results. Note that it says that the various "unusual effects of ultra-high dilutions" have not been adequately replicated, and while it says that some clinical trials have reported "unexpected effects" it goes on to say that evidence in favour of homoeopathy "is scant, is of uneven quality, and is generally poorer quality than research done in allopathic medicine", and goes on to the usual call for more research and an appeal to open-mindedness. This is not a paper that concludes that homoeopathy works. Brunton (talk) 10:57, 27 December 2011 (UTC)

No it is not. No one said it concludes that homeopathy works. As you said it points out that the results are mixed positive and negative; that there has not been enough laboratory research for this phenomena. They point out that three independent systematic reviews of placebo-controlled trials on homeopathy reported that its effects seem to be more than placebo, and one review found its effects consistent with placebo. It certainly differs from the article's view "The collective weight of scientific evidence has found homeopathy to be no more effective than a placebo.[2][3][4][5][6]. This is very clear. --OBenfey (talk) 15:51, 27 December 2011 (UTC)

No, its conclusion doesn't negate the view taken by the article; the evidence cited effectively concludes that while some studies have positive results, the evidence as a whole fails to demonstrate efficacy.

If you want to know more about the "three independent systematic reviews of placebo-controlled trials on homeopathy [that] reported that its effects seem to be more than placebo" I suggest that you read the article rather than the abstract, follow up the references, and find out what they actually concluded.

Kleijnen 1991 concluded that "the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias." Inconclusive, not an unequivocally positive result.

Linde 1997 found results that were "not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition." Even these cautiously positive conclusions were effectively retracted by the same team's 1999 reanalysis of the same data, which concluded that there was "there was clear evidence that studies with better methodological quality tended to yield less positive results" and said that the "evidence of bias weakens the findings of our original meta-analysis. Since we completed our literature search in 1995, a considerable number of new homeopathy trials have been published. The fact that a number of the new high-quality trials...have negative results, and a recent update of our review for the most "original" subtype of homeopathy (classical or individualized homeopathy), seem to confirm the finding that more rigorous trials have less-promising results. It seems, therefore, likely that our meta-analysis [i.e. the 1997 paper] at least overestimated the effects of homeopathic treatments." The first and last named authors of the 1997 paper have stated that "our 1997 meta-analysis has unfortunately been misused by homoeopaths as evidence that their therapy is proven", and the lead author was last year quoted by Der Spiegel as saying "Wir können unsere damalige Schlussfolgerung so nicht mehr aufrechterhalten, denn die positiven Ergebnisse könnten auch durch Fehler in den Studien bedingt sein" ("We can no longer maintain our old conclusions as stated, since the positive results could be due to errors in the studies." - translation courtesy of Hans Adler).

Cucherat 2000 concluded that there "is some evidence that homeopathic treatments are more effective than placebo; however, the strength of this evidence is low because of the low methodological quality of the trials. Studies of high methodological quality were more likely to be negative than the lower quality studies." Again, this is not an unequivocally positive result, and one of the authors has since been quoted as saying that the "review did not reach the conclusion 'that homeopathy differs from placebo'". The article continues, "what he and his colleagues actually found was evidence of considerable bias in results, with higher quality trials producing results less favourable to homeopathy."

Linde & Melchart 1998, the review of trials of classical or individualized homeopathy mentioned in the 1999 Linde paper cited above is also cited in this paper. The table of reviews cites its conclusions that the "evidence suggests effects over placebo. Evidence not convincing because of shortcomings and inconsistencies" but doesn't mention its finding that "when the analysis was restricted to the methodologically best trials no significant effect was seen."

What we have here is a whole series of papers saying variations on "some positive evidence but not convincing because of poor quality, more good quality research needed", with later papers also concluding that the effects decrease as study quality increases, to the extent that the positive results could be due to bias.

Taken as a whole, along with the later Shang et al. analysis these reviews are consistent with the article's stated position that the "collective weight of scientific evidence has found homeopathy to be no more effective than a placebo." This is very clear. Brunton (talk) 17:00, 27 December 2011 (UTC)

Thank you Brunton, that is a good summary of the evidence concerning this point.

OBenfey, I didn't give you any of my personal views on homeopathy, my conclusions are based on the evidence and current scientific theory. So, please do not make up things about others. The article you cited is an opinion piece that was factually incorrect at the time of publication and is certainly out of date now. Acleron (talk) 17:32, 27 December 2011 (UTC)

None of the papers you refer to conclude that homeopathy has NO effect over placebo besides Shang. You confuse "efficacy as a whole" - which your own term- with the effect over placebo. These are different things according to the writers. That's why Linde disputed Shang's conclusion in the Lancet "Homeopathy has no effect over placebo". All the systematic reviews you refer to report mixed results. They are inconclusive. They don't say that "The collective weight of scientific evidence has found homeopathy to be no more effective than a placebo." This is a wrong . --OBenfey (talk) 17:53, 27 December 2011 (UTC)

If they are inconclusive, then they don't demonstrate that homoeopathy works better than placebo.

And don't just take my word for it on these reviews - here's a comment relating to them submitted by Professor Edzard Ernst to the House of commons Science & Technology Committee, and here is his comment on reanalyses of the 1997 Linde paper and about the subsequent evidence (see the section entitled "the evidence is getting weaker"). Brunton (talk) 18:36, 27 December 2011 (UTC)

This is not the same with wikepedia's statement that science has found homeopathy to be a placebo therapy.The papers themselves are referring to a controversy due to mixed results : positive and negative. And according to the Neutral Point of View the editors here have to also include all notable controversies and opinions. Not to pretend that the issue has been settled and all the authors and scientific bodies agree that homeopathic remedies dont differ from placebo pills. This is supposed to be an informative article and not propaganda or polemic against or for homeopathy. --OBenfey (talk) 19:05, 27 December 2011 (UTC)

If you want the article to say that there is a scientific controversy over whether homoeopathy works better than placebo, you need to find reliable sources that have concluded that it works better than placebo. We've been through this before, wth editors claiming that Linde's team had concluded that homoepathy works better than placebo, and that the National Center for Complementary and Alternative Medicine and the American Medical Association have concluded that it works better than placebo, but they completely failed to provide any evidence for this. Brunton (talk) 19:26, 27 December 2011 (UTC)

All the papers and organizations above refer to different authors who dispute each other findings. This is more than enough. But if you want a reliable source to state that, this is one of the many: Clinical trials are less sensitive for determining whether ultra-high dilutions have specific effects than laboratory research, where more rigorously controlled conditions are possible. 'The publication of laboratory investigations of ultra-high dilutions has produced considerable controversy and mixed results on attempted replication (52-54). Still, unusual effects of ultra-high dilutions in rigorous laboratory studies continue to be reported (55-59). Multiple independent replications of this research have not yet been done because there are few investigators in the field (6--OBenfey (talk) 19:39, 27 December 2011 (UTC)

That's the narrative review you have already quoted above, which as you point out says that while "unusual effects" have been reported they haven't been sufficiently replicated. And detecting anomalous effects in water isn't actually the same thing as demonstrating that homoeopathy works better than placebo, by the way. Perhaps that particular issue should be taken to the Memory of water talk page. Can you cite a decent systematic review or meta analysis that has concluded that homoeopathy works better than placebo? Brunton (talk) 19:48, 27 December 2011 (UTC)

. The only thing I m saying is that there is a controversy over the placebo question : the reliable sources describe it as such besides the fact that it appears with letters of the authors who dispute each other findings and methodology. "Clinical trials are less sensitive for determining whether ultra-high dilutions have specific effects than laboratory research, where more rigorously controlled conditions are possible. The publication of laboratory investigations of ultra-high dilutions has produced considerable controversy and mixed results on attempted replication (52-54 This is part of the homeopathy debate according to the writers, always --OBenfey (talk) 21:19, 27 December 2011 (UTC)

You may be saying that there is a controversy over "the placebo question", but you aren't citing any sources for it. Laboratory tests that report apparently anomalous behaviour of water do not show that homoeopathy works better than placebo, no matter how sensitive they are. Showing that a medicine has specific effects in the lab does not mean that it is effective as a medicine. To demonstrate efficacy over placebo you need a placebo controlled clinical trial. Can you cite any peer-reviewed meta-analyses or systematic reviews by these "authors who dispute each others findings and methodology" that have concluded that homoeopathy is more effective than placebo? Brunton (talk) 21:44, 27 December 2011 (UTC)

According to the authors of the above studies their view differs. According to the available reliable sources there is a controversy over interpretation on Homeopathy effectiveness and whether it is a placebo effect. It is not my imagination that the there are different views. The reliable sources state it. Homeopathy is a controversial area of CAM because a number of its key concepts are not consistent with established laws of science (particularly chemistry and physics). Critics think it is implausible that a remedy containing a miniscule amount of an active ingredient (sometimes not a single molecule of the original compound) can have any biological effect—beneficial or otherwise. This is more than enough. --OBenfey (talk) 22:44, 27 December 2011 (UTC)

"According to the authors of the above studies their view differs." Not according to the peer-reviewed work they have published - unless, of course, you can cite peer-reviewed work they have published that has concluded that homoeopathy works better than placebo.

There is a controversy between the scientific community and those who believe it works, because the published research doesn't show that it works and it contradicts pretty much the whole of science. But there isn't a scientific controversy over this - all the reviews over the last 20 years find basically the same thing - some studies showing efficacy, but not convincing because of poor quality and the possibility of bias, with better quality research less likely to be positive. Can you cite a review that says anything other than this? Brunton (talk) 23:02, 27 December 2011 (UTC)

This is your personal opinion. The sources which you cite dispute this: all the groups of authors are published in mainstream high quality sources. And they disagree on whether it is only placebo or not. This is called controversy not by me but by the same sources. So our personal opinions don't really matter. You appear too anxious not to include this information in your article. According to the principles of wiki , it should be included. But it seems that it there is a special situation here: Just edit out whatever seems controversial or positive no matter how exceptional is the source--OBenfey (talk) 00:54, 28 December 2011 (UTC)

That no systematic/meta-studies can say that homeopathy has any effect greater than placebo is a fact, not an opinion. Unless someone can produce, as Brunton asks, a study of similar stature to say the Shang study then there is no controversy. Anybody can say the word controversy but showing there are results that are different from those known is a different matter. The scientific theories that govern our physical existence such as QED, the law of mass action and our knowledge of biochemistry etc predict that if nothing is present, nothing happens. The clinical trials of homeopathy agree perfectly with that prediction. There is nothing scientifically controversial here.

You have accused Brunton and myself of putting forward personal opinions and not applying NPOV. Please follow another wiki principle - AGF Acleron (talk) 05:37, 28 December 2011 (UTC)

You have to read carefully what the reliable sources write. They say that according to the writers three independent systematic reviews of placebo-controlled trials on homeopathy reported that its effects seem to be more than placebo, and one review found its effects consistent with placebo.This is a peer review article in high impact journal. Also some of they above sources that Brunton refered to, dispute that Homeopathy has no effect over placebo. They don't have to convince you personally that they are correct. Since their opinion appears in high quality reliable sources it is qualified for inclusion, not matter if you or me disagree. This is the way wikipedia works or supposes to work, It supposes to report all notable controversies and the criterion for distinguishing them it is their appearance in high impact reliable sources. That's all. --OBenfey (talk) 06:34, 28 December 2011 (UTC)

They may say that the effects seem more than placebo, but all also point to shortcomings in the evidence that prevent them concluding that it actually does have effects over placebo. And they are all consistent in this. If published reviews have concluded that homoeopathy works better than placebo, please cite them.

We can't Teach the Controversy if there is no evidence of a scientific controversy. Brunton (talk) 07:05, 28 December 2011 (UTC)

Is this a joke? The reliable sources use this term. Authors dispute over the evidence in the Lancet. But wikipedia or the groups which control this article do cannot really see it. Which controversy? Maybe the reliable sources ( The Lancet, etc ) are not reliable enough at least compare to skeptics blogs. Maybe you are right. --OBenfey (talk) 17:56, 28 December 2011 (UTC)

For the record, I think homeopathy shouldn't be taught or used anywhere outside of Hogwart's Academy. I'm entirely confident that, if and when some independent researchers waste time and resources thoroughly testing this nonsense, they will come to the inevitable conclusion that drinking water cures nothing but thirst.

That being said, Obenfey has brought a reliable source that shows some small studies have produced some results which are not entirely consistent with the null hypothesis. However, as pointed out within the cited article, these studies have their share of problems. Or, more precisely, there simply isn't enough reliable data to positively conclude it doesn't work, (despite the fact that there is no plausible mechanism for it to have any impact on the human body beyond the effect of tap water.) So, I believe it should be permitted to be included.

I don't think it's fair to say there's a "scientific controversy" here. But, something along the lines of "the scientific evidence does not support this, but some argue additional research is needed" may be appropriate. Again, I'm reluctant to sound like a defender of such a silly idea, but I'm a firm believer that my opinion on the matter shouldn't impact the article.JoelWhy (talk) 19:21, 28 December 2011 (UTC)

some argue additional research is needed about ghosts, magic wands, penis thieves, astrology and wikipedia. Almost everything is researched by somebody. Bulwersator (talk) 19:31, 28 December 2011 (UTC)

Again, reliable source.JoelWhy (talk) 19:39, 28 December 2011 (UTC)

The reliable sources cited in this page characterize Homeopathy controversial not among believers and scientists, but among scientists whose systematic reviews appear in high impact journals and have already been cited in the wikipedia article. Hence, it is fair to include what these high quality sources say - not what we believe homeopathy really is. --OBenfey (talk) 21:06, 28 December 2011 (UTC)

The article that OBenfey has cited is an opinion piece. It does not introduce any more evidence to the debate. It was published in 2003 but is superseded by the Shang study published in 2005. This is the pivotal study which introduced more evidence by the rigorous way in which clinical trial results were analysed. (btw all previous combined studies did not support the hypothesis that homeopathy is any more than a placebo effect and that included Linde). It must be the evidence that leads us, otherwise all opinions become equally valid. So there is no scientific controversy. Scientific controversy would result if a properly run double blind randomly controlled trial of high power showed that homeopathy had an effect greater than placebo and this was repeatable. To date, this has not happened.

It is mathematically impossible to determine that any treatment does not work. All that can be done is to give the probability that a result is different from the null hypothesis (in this case that homeopathy is no different from the placebo). A limit of 5% is taken that means in perfect conditions, 1 trial in 20 will show a positive result even when no effect occurs. In small, poorly controlled and performed studies, the probability of false positives goes up. You can find extensive discussion of this effect in the archives. This is why the Shang study is so important, for the first time trials were compared in a rigorous way. If the Shang results could be overturned then there will be genuine controversy. Again, to date, apart from criticism from homeopaths, it still stands.

Therefore my conclusion is that no new evidence has been produced other than an 8 yo opinion and no change to the article on this point is either necessary or desirable. Acleron (talk) 21:12, 28 December 2011 (UTC)

Hmmm, that is a rather persuasive argument, Acleron. I don't know that it's fair to classify the other study strictly as an "opinion piece", (seems more like a meta-analysis, doesn't it?) But, your overall point is a good one.JoelWhy (talk) 21:26, 28 December 2011 (UTC)

It looks to me more like a narrative review than a meta-analysis or systematic review. Brunton (talk) 23:36, 28 December 2011 (UTC)

Your view is an opinion piece. The criterion is what the reliable sources say and not what you think it is right. Shang;s study was heavily criticized in different papers. --OBenfey (talk) 21:34, 28 December 2011 (UTC)

Obenfey, can you please provide citation(s) of where the Shang paper has been criticized?JoelWhy (talk) 21:41, 28 December 2011 (UTC)

Of course. This is really easy. I will do very soon. --OBenfey (talk) 21:45, 28 December 2011 (UTC)

Is homeopathy controversial according to reliable sources ?

Is this a reliable source which describe the scientific controversy over homeopathy? Yes or no ?  : Annals of Internal Medicine [2] --OBenfey (talk) 21:34, 28 December 2011 (UTC)

Part of the page was deleted - I don;t know how to fix it. Sorry,--OBenfey (talk) 21:41, 28 December 2011 (UTC) Here is one more reliable source disputing Shang. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67878-6/fulltext?_eventId=login There are more--OBenfey (talk) 21:57, 28 December 2011 (UTC)

That's a letter, rather than another meta-analysis; and it's bookended with "We agree that homoeopathy is highly implausible" at the start and "Our 1997 meta-analysis has unfortunately been misused by homoeopaths as evidence that their therapy is proven'" at the end. Some controversy. bobrayner (talk) 22:06, 28 December 2011 (UTC)

Well, that's written by the same researchers who wrote the article in question. Their declaration that "we have no conflict of interest" is hardly persuasive.JoelWhy (talk) 22:08, 28 December 2011 (UTC)

Not only is the letter not peer-reviewed, but it doesn't state a conclusion that homoeopathy works better than placebo.

There is just as much of a scientific controversy here as there is about whether evolution happens: i.e. none.

None of the published reviews so far cited concludes that homoeopathy works better than placebo. If you want the article to say that there is a controversy over the statement that the weight of scientific evidence does not show that homoeopathy works better than placebo, you will need to cite published reviews that conclude that it does. That is how wikipedia works; it follows the sources. Brunton (talk) 23:51, 28 December 2011 (UTC)

Can I suggest a little thought experiment to approach this discussion from a different angle? Essentially it is about the question What constitutes quality information? Information can have, broadly speaking, two roles:

a) To improve the decision making process (and change behaviour)

b) To reduce uncertainty

To start with a): is it imaginable that any physician (or group of physicians) would change medications from regular to homeopathic ones based on the finding of articles discussed in this thread? This answer is No (emphatically so). [e.g. Bandolier, passim]

The option b) is more aimed at patients or parents. Is it imaginable that a patient seeking medical advice would switch from a regular doctor to a homoeopathist? To concentrate minds: let’s imagine a town with only two doctors, one practicing regular medicine, one specialising in homeopathy (exclusively). Would a patient change from a regular to a homeopathic advisor? Now would she? Really? Are you sure? No? Than the answer for this scenario would be No (not quite so emphatically).

Conclusion: the results of the studies debated here, be they individual trials or meta-analyses, do not provide signals. They are mere noise and can be ignored. They are unlikely to change anybody's behaviour Sleuth21 (talk) 07:16, 29 December 2011 (UTC)

First of all, again I don't characterize myself homeopathy as controversial but the reliable sources.

1. Controversies Regarding Homeopathy :Homeopathy is a controversial area of CAM because a number of its key concepts are not consistent with established laws of science (particularly chemistry and physics). Clinical trials are less sensitive for determining whether ultra-high dilutions have specific effects than laboratory research, where more rigorously controlled conditions are possible. The publication of laboratory investigations of ultra-high dilutions has produced considerable controversy and mixed results on attempted replication (52-54). Still, unusual effects of ultra-high dilutions in rigorous laboratory studies continue to be reported (55-59

2. The results of the review may be complicated by publication bias, especially in such a controversial subject as homoeopathy.

3. Reviews on homeopathy often address general questions. While the evidence is promising for some topics the findings of the available reviews are unlikely to end the controversy on this therapy.

4. Linde disputes the findings and methodology of Shang 2005; his views are different ( positive for some conditions but inconclusive in general ) and he is citing his own studies to support that. He does not have to show proof that homeopathy works in order to disagree with Shang. He articulates his own opinion which is clearly against the Lancet and against Shang and the same time not in line with homeopaths.

Saying the Linde does not really dispute Shang while he sends such a strong letter to the Lancet is just pure hypocrisy and pretension which had led the article to be like a 3rd rate skeptics blog. --OBenfey (talk) 07:23, 29 December 2011 (UTC)

There may well be a controversy, but it doesn't matter in the real world. Much of the argument about homeopathy ends up being about trivial differences of little or no clinical relevance. Until large and well conducted randomised trials tell us differently, the conclusion is that homeopathy does not work, and its use instead of remedies of proven effectiveness is not a matter of trivial implication. Members of the public are relieved of much money each year by homeopaths. There's little evidence they are relieved of any suffering. http://www.medicine.ox.ac.uk/bandolier/band116/b116-8.html Many more studies need to be done and/or replicated to establish the benefit of homeopathy. A meta-analysis of 89 double-blinded, placebo-controlled trials of homeopathy states that "...the clinical effects are not completely due to placebo alone. http://www.med.umich.edu/pediatrics/ebm/cats/homeodiarrhea.htm etc. etc. Sleuth21 (talk) 07:55, 29 December 2011 (UTC)

OBenfey:

1. The first source is describing a controversy between the science and proponents of homoeopathy - it says that homoeopathy is controversial because it is contradicted by the science. Its assessment of the research into homoeopathy's efficacy is entirely consistent with the article's position: see the section headed "The Status of Homeopathy Research". As already noted, he second one describes a controversy over high dilution effects, not over the efficacy of homoeopathy. It is mentioned in the first of the two sources Sleuth21 has just cited, by the way: "Even ardent proponents of homeopathy who have performed a critical overview conclude that homeopathy 'should not be substituted for proven therapies'"

2. This source is now 20 years old; there have been a lot more reviews pubished since then. it says that the evidence is "not sufficient to draw definitive conclusions". So do all the other reviews published over the 20 years since it was published, with the results gradually getting worse for homoeopathy.

3. The controversy is not over the science, it is because some people insist that it works in the face of the evidence.

4. "...his views are different ( positive for some conditions but inconclusive in general ) and he is citing his own studies to support that." No, the letter does not report a conclusion that homoeopathy works better than placebo for some conditions but not others, it says "If homoeopathy (or allopathy) works for some conditions and not for others (a statement for which there is some evidence)"; "there is some evidence" is not the same as a conclusion that it actualy does work. His own studies that he cites do not actually conclude that homoeopathy works better than placebo. If you want to claim that Linde has concluded that homoeopathy works better than placebo, then you will have to cite published peer-reviewed work in which he has concluded this. The letter makes no such statement, and is not peer-reviewed.

Homoeopathy holds itself out as a system of medicine, and needs to be assessed here on that basis - the appropriate view is the mainstream medical and scientific view, and there is no real controversy there. Brunton (talk) 09:54, 29 December 2011 (UTC)

Sleuth21: the source for that statement that "...the clinical effects are not completely due to placebo alone" is a 1997 paper that has already been discussed above. A later reanalysis of the same data by substantially the same team of authors found that "evidence of bias weakens the findings of our original meta-analysis" and because of this and the results of more recent high-quality trials concluded that the 1997 paper had "at least overestimated the effects of homeopathic treatments". The study of diarrhoea cited there (Jacobs J, Jimenez LM, Gloyd SS, et al. Treatment of acute childhood diarrhea with homeopathic medicine: a randomized clinical trial in Nicaragua. Pediatrics. 1994;93:719-725.) has, according to the AMA, "been criticized for inconsistent/incorrect data analysis; use of different diagnostic and treatment categories but combining them in the conclusions of efficacy; and lack of chemical analysis of different treatments. The clinical significance of the results, given the self-limiting condition being studied, has been called into question." See Sampson W, London W. Analysis of homeopathic treatment of childhood diarrhea. Pediatrics. 1995;96:961-964. Brunton (talk) 10:07, 29 December 2011 (UTC)

Thanks, Brunton, but I am keenly aware of that. I actually referred to the first part of the ‘further information’ bit of the synopsis from the University of Michigan Department of Pediatrics, Evidence-Based Pediatrics Web Site: 'Many more studies need to be done and/or replicated to establish the benefit of homeopathy'. That their findings were subsequently discredited is only to be expected. Had I wanted to support homeopathy I would have quoted for instance the questionable paper from the (then) London Homeopathic Hospital, PMID: 8628632, which mentions the Jacobs study. But I don’t so I didn’t. Or are we talking at crossed purposes? Sleuth21 (talk) 12:20, 29 December 2011 (UTC)

Maybe we are at cross purposes. A statement that more good quality research is needed is a rider to the conclusions of pretty much every systematic review from Kleijnen onwards. Since the more recent ones also tend to state that the better quality research tends not to show positive results (see Linde 1999, Cucherat 2000, and especially Linde 1998 and Shang 2005) and all of them agree that the evidence isn't enough to conclude that it works it doesn't look too good for homoeopathy, or indicate much in the way of a controversy over whether homoeopathy has effects over placebo. Brunton (talk) 12:49, 29 December 2011 (UTC)

We obviously are at cross purposes. I'll try to figure out why and will let the matter rest for a couple of days. Thanks for your comments of the draft Lead re-design in my sand-box. Sleuth21 (talk) 13:01, 29 December 2011 (UTC)

It does not have to say that Homeopathy works for everything or without a doubt. The fact is that they heavily criticize the Shang study its methodology and its conclusion, they cite their own study to argue against it . But you, for some reason, you want your readers to believe that every researcher who investigated homeopathy has adopted similar views to Shang. This is misinformation , lying, censorship, biased and everything bad wikipedia tries to not be. That's all. --OBenfey (talk) 18:42, 29 December 2011 (UTC)

The criticisms of the Shang study's conclusions are just that - an opinion on whether a particular study's methodology adequately supports its conclusions - they belong with discussion of that particular study, and don't state any particular conclusion about homoeopathy's efficacy.

They cite their own study to support the statement that "there is some evidence" that homoeopathy works for some conditions and not others, not to support a conclusion that homoeopathy works better than placebo. We cannot use the letter as a source for a statement that it doesn't make.

I am not saying that "every researcher who investigated homeopathy has adopted similar views to Shang"; I am saying that all the systematic reviews and meta-analyses from Kleijnen onwards have produced results that are consistent, starting with Kleijnen's conclusion that there is evidence that it works but this is inconclusive because of its poor quality and call for more good quality research, then as more work is done moving on to reviews that also find that the better quality studies tend to find no effect over placebo, and culminating with Shang. There are no reviews that have concluded that homoeopathy has effects over placebo, apart from the 1997 Linde analysis, which was effectively retracted as a result of its authors' 1999 reanalysis of the same data, and, as Professor Edzard Ernst notes, five further reanalyses have "arrived at a less than positive conclusion" and a further "11 new and independent systematic reviews published after Linde's article also fail to conclude that homeopathy is effective". The conclusions of all these studies, published over the last 20 years, are basically consistent.

I advise you to read WP:AGF. Brunton (talk) 19:31, 29 December 2011 (UTC)

Some scientists like Ernst believe that all the meta analyses arrived at a less than positive conclusion" and a further "11 new and independent systematic reviews published after Linde's article also fail to conclude that homeopathy is effective"; some others reviewers published to equally high impact sources think that conclusion that Shangs findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement. that despite skepticism about the plausibility of homeopathy, some randomized, placebo-controlled trials and laboratory research report unexpected effects of homeopathic medicines and Until homeopathy is better understood, it is important that physicians be open-minded about homeopathy's possible value and maintain communication with patients who use it.

These views are really different. Whoever promotes the idea that all the scientific views can be condensed to the view that homeopathy is basically placebo provides misinformation. Because part of the scientists who have investigated the phenomenon openly and clearly dispute this conclusion. I don't understand the good faith thing. If something is a lie we have to say it. --OBenfey (talk) 23:27, 29 December 2011 (UTC)

If there are systematic reviews or meta-analyses that have concluded that homoeopathy works better than placebo, please cite them. If not, we can't imply that reviewers have concluded that it works better than placebo. Brunton (talk) 00:14, 30 December 2011 (UTC)

You don't have to imply anything. You just have to stop stating that the collective weight of evidence has found homeopathy to be more no more effective than a placebo because part of the scientists who systematically study this evidence dispute that.--OBenfey (talk) 01:27, 30 December 2011 (UTC)

It has been pointed out several times that the 'collective weight' or more accurately, the vast majority, have shown exactly that no evidence has been found that indicates any difference between homeopathic preparations and placebo. It would be perverse to state anything else. If a study of sufficient quality existed that showed there was an effect beyond placebo it would a) be controversial (indeed!) and b) lead to changing the statements in the article. To change the statement of the conclusions on the basis of opinion rather than evidence would be misleading. Acleron (talk) 02:53, 30 December 2011 (UTC)

Misleading is to imply that the vast majority of the researchers agrees that the collective weight finds that the homeopathy is only placebo. Few groups of authors have studied systematically the evidence on Homeopathy and a significant part of them dispute that Homeopathy is only placebo. The fair thing is to state the facts : who is saying what; if you want to give emphasis to the latest meta analysis ( Shang)- which is reasonable- you have to also present the notable objections and criticism as long they appear in high quality sources. If you (or we ) want to be consistent with the neutrality guidelines wikipedia supposes to function. --OBenfey (talk) 03:16, 30 December 2011 (UTC)

What accentuates all of these findings in practical clinical trials is that science would not predict that homeopathy could possibly work. When you dilute some active ingredient to the point where literally none of it is left - then what you have is just water. You don't need to do clinical trials to know that water doesn't cure things at the rate that homeopathists claim. The only way that this nonsense could possibly work would be if the bizarre claims of 'imprinting' onto water molecules were somehow to be possible. But again, there is absolutely zero reputable scientific evidence that shows any such effect. So it's not like there is some murky, fuzzy results from clinical trials - it's that the whole mechanism that underpins homeopathy is hokum - and the trials that have been done confirm that.

To put this in scientific context, if someone claims that invisible pink pixies can cure cancer - we really don't need to do a whole lot of clinical trials to dismiss that claim. The ethical issues surrounding such trials would be exceedingly difficult. How can we justify taking a whole lot of sick people and treating half with a placebo and the other half with invisible pink pixies - when they would be much better served by being given conventional cancer treatments?

On ethical and cost grounds alone, one must first demonstrate the existence of invisible pink pixies and having done that, then perhaps there is merit in testing the cancer cure claims. Without that initial demonstration, we simply cannot expect there to be large numbers of comprehensive clinical trials. That's the case with homeopathy. What should happen is that someone should demonstrate that this "imprinting" onto water is plausible via some kind of non-medical experiment. If this incredibly unlikely concept turns out to be true - and we can explain how the water is not also imprinted upon by every trace impurity imaginable - then we would proceed to animal studies. If that shows conclusive proof of a homeopathic effect - then, and only then, should full, large-scale, double-blind human clinical trials be undertaken.

The "controversy" that exists here is not between one reputable scientist and the next - it's between reputable scientists and disreputable companies and their sadly naive consumers. SteveBaker (talk) 03:41, 30 December 2011 (UTC)

From the scientists and sources I have cited who or what you think has no reputation and does not qualify to be cited here ? I m asking this question because you appear to have no idea what has been said so far. --OBenfey (talk) 03:54, 30 December 2011 (UTC)

You have been shown the conclusions of the studies under discussion. Please point to the ones that claim that there is a significant difference between a homeopathy preparation and placebo. We are not talking about side issues, such as 'more work needs to be done', 'I don't like the way you have done that' etc. You are disputing that the vast majority say'we can find no significant difference between homeopathy preparations and placebo', please point out the high quality systematic studies or meta-analyses that support your position. Acleron (talk) 05:28, 30 December 2011 (UTC)

There is no such a thing as vast majority among the authors who wrote on homeopathy's effectiveness. Only Shang says that it is only placebo. I listed in this talk page, Linde and all ( Linde himslef states that his reviews arrive to different conclusions from Homeopathy is only placebo) Annals of internal medicine, Lüdtke R, Rutten AL. Lüdtke R, Rutten A L. which all dispute the conclusion Homeopathy is only placebo. How many times I need to do it? --OBenfey (talk) 05:45, 30 December 2011 (UTC)

OK, lets look at Ludtke. First the results which are All trials were highly heterogeneous (I2=62.2%). Homeopathy had a significant effect beyond placebo (OR=0.76; 95% CI: 0.59-0.99; p=0.039). When the set of analyzed trials was successively restricted to larger patient numbers, the ORs varied moderately (median: 0.82, range: 0.71-1.02) and the P-values increased steadily (median: 0.16, range: 0.03-0.93), including Shang's results for the eight largest trials (OR=0.88, CI: 0.66-1.18; P=0.41). Shang's negative results were mainly influenced by one single trial on preventing muscle soreness in 400 long-distance runners. They are looking at the Shang trial, so it is NOT new data. They find that with all trials the significance is 0.039. With the best trials the significance is 0.41. They try to cherry pick the trials but their result is exactly the same as Shang. Their conclusion is The meta-analysis results change sensitively to the chosen threshold defining large sample sizes. Because of the high heterogeneity between the trials, Shang's results and conclusions are less definite than had been presented. The first sentence is again exactly the result from Shang. The second sentence is the very best criticism they could make, but even that weak retort is not supported by any results they have. So far we have seen the letter from Linde criticising Shang but saying his results are pretty much the same and we have Ludtke with the same analysis of the same data as Shang and arriving at the same conclusion. Acleron (talk) 06:18, 30 December 2011 (UTC)

The Ludtke and Rutten paper, incidentally, does not actually state a conclusion that homoeopathy works better than placebo: "Our results do neither prove that homeopathic medicines are superior to placebo nor do they prove the opposite." It's a discussion of the fsirly obvious point that if you change the studies considered by a review, the conclusions can change. As with the "Linde letter", it is relevant only in a discussion of the Shang paper, or a discussion of meta-analysis in general, not homoeopathy generally.

There's a discussion of how its results affect the conclusions of Shang here. Brunton (talk) 08:53, 30 December 2011 (UTC)

You have to stop repeating the same thing as you have not heard what it has been written here. Part of the scientists who systematically study the evidence on homeopathy dispute the articles 's current point of view Homeopathy = placebo. They don't have to prove homeopathy to disagree with the current point of view of the article. The authors state that - it is not my personal opinion. Isn't better for the article to reflect all the major opinions on Homeopathy;s effectiveness instead of trying to edit out whatever they it looks positive for homeopaths? This is equally wrong as it would be wrong to say that there are double blind trials which show homeopathy has been definitely proved as a therapy. --OBenfey (talk) 09:11, 30 December 2011 (UTC)

I quote from a contribution above: The "controversy" that exists here is not between one reputable scientist and the next - it's between reputable scientists and disreputable companies and their sadly naive consumers and offer this comment: Even if those companies were all reputable and their sadly naïve consumers were not so afflicted (actually, some are very intelligent and certainly not naive), the statement in our article the collective weight of scientific evidence has found homeopathy to be no more effective than a placebo would still be valid. The moral standing of parties (or their naivety (sad or otherwise)) has no place in a scientific debate. Even if Newton was (?were) a moral shit, his laws of motion would still be true (in classical mechanics). Trying to taint the character of parties involved in a debate is usually indicative an ever so slight moral defect in the tainter. We should stop this tainting, however well intended it may be. As far as the inclusion of that sentence in our article is concerned: it should stay and we should perhaps move on? Sleuth21 (talk) 09:49, 30 December 2011 (UTC)

You still haven't cited a source in which they have concluded that it works better than placebo. Saying that they think homoeopathy works better than placebo because they have criticised a study that has concluded that its results are "compatible with the notion that the clinical effects of homoeopathy are placebo effects" would clearly be in conflict with WP:SYN. Brunton (talk) 10:00, 30 December 2011 (UTC)

Do you realize that what you are writing makes no sense? Maybe not and that it is really strange. Someone is telling you in writing that s/he disagrees with x statement and you keep informing other people that s/he does not really mean it. Do you know how we call this ? Maybe not. --OBenfey (talk) 10:17, 30 December 2011 (UTC)

"Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources." - WP:SYN. Brunton (talk) 10:43, 30 December 2011 (UTC)

Wikipedia is an encyclopedia of knowledge. Pretending that diluted preparations of X somehow confer an advantage of the original undiluted preparation would be anathema to the point of this project. It would be anathema because all the laws of physics hold a great big sign that says "homeopathy, idiot be thine name." Topics like homeopathy have very little to appeal to in the context of reliable sources because the concept is so obviously bullshit that very few scientists are willing to waste the time in testing it. It's like making the hypothetical statement that gravity is suspended for objects that contain 53.43234347 kilos of mass at exactly 22.987345987345 degrees Celsius - we understand enough about the laws to physics to know that any experiment would be a pointless exercise. In the same vein, if a study were published that found incredibly poor evidence of such an idea, our article on Gravity would certainly not mention it until there was something to mention (i.e. significant coverage in multiple independent sources). To summarize: because homeopathy makes incredible claims that fly in the face of thousands of known physical concepts, it requires extraordinary evidence if it hopes to compete in any serious way, and until it does compete in a serious way in the scientific community, it will not compete here. N^oformation ^Talk 10:47, 30 December 2011 (UTC)

Can you stop repeating your personal opinions and respond to what has been said?--OBenfey (talk) 22:40, 31 December 2011 (UTC)

Excellent stuff, NoInfo. I wish I had said that – You will, sleuth21, you will! (pace Whistler / Wilde). Can I quote you outside Wikipedia, just replacing the b/s bit by ‘and utterly wrong’? Your comment is a pleasure to read. Thanks and Happy New Year Sleuth21 (talk) 12:41, 30 December 2011 (UTC)

I now see your problem OBenfy, you wrote They don't have to prove homeopathy to disagree with the current point of view of the article.. In the science of clinical trials, they DO have to prove exactly that to contest the article. The statistics used to provide conclusions can only prove that two items are distinct. So in our case, they can prove that a homeopathy preparation has a distinct effect from that of placebo, no statistics can prove that the two are identical. So when no difference can be proven the conclusion is automatically that no significant difference can be found. This is the case with the results we are discussing. As no evidence has been presented to show there is a difference, then the statement that there is no significant difference between placebo and homeopathy product is not only perfectly proper but mandatory.

This can be a confusing topic without the required background. This article may be useful to you in seeing how the article is derived from the evidence.

You will of course have noticed in the references you have cited that none of the authors contest the aboveAcleron (talk) 13:27, 30 December 2011 (UTC)

Edit request on 30 December 2011

The following sentence looks like an opinion and therefore should be removed from the article. There are equal scientific evidences that homeopathy has been effective in curing illnesses, habits with little/no side effects as compared to chemical-based allopathy medicines. "The collective weight of scientific evidence has found homeopathy to be no more effective than a placebo" Sky in wiki (talk) 07:07, 30 December 2011 (UTC)

We don't remove properly sourced opinions. They are allowed. Sometimes we attribute them, and sometimes we don't, but the fact they are "opinions" is not a legitimate reason for removal. That's not the way Wikipedia works. Our articles contain facts and opinions about subjects, including controversies, which always contain opinions. -- Brangifer (talk) 07:46, 30 December 2011 (UTC)

Homeo news

Some interesting things that might be usable:

• Boots told to stop making medical claims for pills with no active ingredient. The Nightingale Collaboration

• Homeopathy: to sell or not to sell? Chemist + Druggist

Edzard Ernst was asked to comment on the pharmacists’ responses:

A C30 potency of a homeopathic remedy is so dilute that a pill would need to have roughly the diameter of the distance between the Earth and the Sun (1.48 x 10^11 metres) to contain a single molecule of active substance. The totality of the around 200 clinical trials of homeopathy fails to show that homeopathic remedies differ from placebos. Thus homeopathy is biologically implausible and clinically disproven. According to the General Pharmaceutical Council’s (GPhC) standards of conduct, ethics and performance, UK pharmacists must “be honest and trustworthy”. In particular, they “must explain the options available to patients and the public, including the risks and benefits, to help them make informed decisions [and] make sure the information [they] give is impartial, relevant and up to date”.

This leaves UK pharmacists essentially only two choices. They can sell homeopathic products and violate their own ethical standards, or they comply with their ethical code by being honest and providing the relevant information to their customers. The latter would mean telling them that the remedy contains no active material and has no effects. In this case, very few customers would buy the product.

The code makes it clear that patients’ safety is paramount. Selling products that are not demonstrably effective gives them undue credence. This can seriously jeopardise patients’ safety. Consumers will think that, as these products are for sale in pharmacies, they are evidence-based. Thus they may use them for treating serious conditions which obviously would do harm.

In conclusion, the sale in pharmacies of homeopathic remedies – and other alternative treatments that are unproven or disproven – is unethical. The GPhC’s standards of conduct could hardly be clearer when stating that “your conduct will be judged against the standards and failure to comply could put your registration at risk”. [Emphasis added]

Brangifer (talk) 06:58, 31 December 2011 (UTC)

Excellent news! All three items (but for the druggists it’s still an ethical dilemma). Prof. Ernst brilliant as ever. Let’s raise an extra glass tonight. Cheers! Sleuth21 (talk) 08:19, 31 December 2011 (UTC)

'[We] would also recommend that homeopathic preparations are only sold if they are being used for a minor or self-limiting condition, and never to treat or prevent a serious condition. Naturally the pharmacist should only supply a product where they are satisfied that it is safe and a preparation that has been sourced from a reputable supplier. For this specific scenario it would be worth exploring the reasons behind the customer’s aversion to ‘drug’ treatments to discuss why there is a ‘distrust’ of conventional medicines. Wing Tang, senior professional support pharmacist: legal and ethical lead, Royal Pharmaceutical Society'. From the a.m. item in Chemist and Druggist. [Emphasis added] Sleuth21 (talk) 08:46, 31 December 2011 (UTC)

"I don’t really want to fight with you guys over whether or not homeopathy works. But the evidence (facultyofhomeopathy.org/research/rcts_in_homeopathy) is much more positive than most of you are saying. Please look for yourself and make your decision. Or if you take the Wikipedia conclusion, good luck to you sir. James McMurray, community pharmacist" [Emphasis added] and reply "If you genuinely believe that there is ‘more’ and better evidence to support the use of homeopathy than the use of paracetamol, ibuprofen, aspirin, clotrimazole, hydrocortisone, aciclovir, lactulose, potassium citrate, loperamide, loratadine, cetirizine, omeprazole, ranitidine, mebeverine, hyoscine, malathion, diclofenac, fluconazole and promethazine then maybe you need to modify how you interpret evidence. Joseph Bush, academic pharmacist, in response to James McMurray" - WP:UNDUE :) Bulwersator (talk) 08:47, 31 December 2011 (UTC)

You are right, Bulversator. I added the comment from Wing Tang, RPS just now – look at its timing - it must have clashed with yours in mid-air. No gloating was intended, but I still raise a glass, quietly, for myself. Sleuth21 (talk) 09:07, 31 December 2011 (UTC)

Jonas, Linde views on Homeopathy ? Do they believe that it is a placebo therapy?

Second, problems with pooling are not discussed. Pooling of data from clinical trials makes sense only if all the trials measure the same effect. In our 1997 meta-analysis, we justified the pooling of different interventions, conditions, and outcomes on the basis that, if homoeopathy is always a placebo, all trials measure, in principle, the same thing. There are major limitations associated with this assumption. If homoeopathy (or allopathy) works for some conditions and not for others (a statement for which there is some evidence4), then interpretation of funnel plots and meta-regressions based on sample size is severely hampered. Since sample size is not independent of the disease, intervention, and outcome, it is impossible to separate the influence of bias from the true effect size by this method. Therefore, restricting an analysis to the largest studies risks producing a false-negative result. Furthermore, since the main analysis is based on only eight and six (probably unmatched) studies, the outcome could easily be due to chance, as is suggested by the large confidence intervals. Given these limitations, Shang and colleagues' conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement. The Lancet should be embarrassed by the Editorial5 that accompanied the study. The conclusion that physicians should tell their patients that “homoeopathy has no benefit” and that “the time has passed for … further investment in research” is not backed at all by the data. Our 1997 meta-analysis has unfortunately been misused by homoeopaths as evidence that their therapy is proven. We now find it extremely disappointing that a major medical journal misuses a similar study in a totally uncritical and polemical manner. A subversive philosophy serves neither science nor patients.--OBenfey (talk) 22:45, 31 December 2011 (UTC)

Once again: you are trying to use a letter that does not state a conclusion that homoeopathy works better than placebo to suggest that its authors think homoeopathy works better than placebo. If you want the article to say that they have concluded that homoeopathy works better than placebo you will need to cite work that they have published that has actually concluded this. See WP:SYN: "Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources", and also bear WP:MEDRS in mind. Brunton (talk) 10:06, 1 January 2012 (UTC)

Linde and Jonas state in writing that the evidence on Homeopathy is mixed. They DONT concur with the shangs view that all is placebo -the point of view the article has adopted. There is no synthesis - this is a direct statement by the authors. Please stop the misinformation. --OBenfey (talk) 14:44, 1 January 2012 (UTC)

The only direct statement about homoeopathy in the letter can be found in the opening paragraph: "We agree that homoeopathy is highly implausible and that the evidence from placebo-controlled trials is not robust." That's entirely in line with the position taken by the article, which bases its position on the conclusions of peer-reviewed secondary sources, as per WP:MEDRS, and, by the way, also states that the evidence is mixed: "While some individual studies have positive results, systematic reviews of published trials fail to demonstrate efficacy". Shang's conclusion is not that "all is placebo", it is that its findings are "compatible with the notion that the clinical effects of homoeopathy are placebo effects." You have misinterpreted Shang, misinterpreted the article's position, and misinterpreted Linde and Jonas's letter.

The letter does not state that its authors have concluded that homoeopathy works better than placebo, so cannot be used as a source for this statement, and is not a peer-reviewed source. Brunton (talk) 17:18, 1 January 2012 (UTC)

Brunton,the letter speaks for itself.

Shangs's findings are "compatible with the notion that the clinical effects of homoeopathy are placebo effects.

" Linde's letter says Given these limitations, Shang and colleagues' conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement.

Who is really misrepresenting the sources? --OBenfey (talk) 20:52, 1 January 2012 (UTC)

It is a comment on whether the conclusions of the study are supported by its methodology. It is a comment specifically about the Shang paper, not a statement that homoeopathy works better than placebo, or any kind of conclusion about homoeopathy itself. Brunton (talk) 23:34, 1 January 2012 (UTC)

They dispute both methodology and conclusion.

Shang and colleagues's conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement.Their conclusion differs according to their own statement. Saying that the authors agree with the "collective weight of evidence founds homeopathy no more effective than a placebo" is false and totally inappropriate. --OBenfey (talk) 01:37, 2 January 2012 (UTC)

The logic is quite clear, either you can show a significant difference between a treatment and placebo or you cannot. There is no third choice. Your conclusion has to be either of those two. So the question is "Has Linde et al showed a significant difference between treatment and placebo?" The answer is quite clear, no matter how they squirm, they did not show a difference. Therefore, the conclusion is "No difference can be detected between treatment and placebo". You have been repeatedly asked to provide evidence that there is such a difference and you haven't responded except to keep coming back to an unrefereed letter. Several editors have explained why that statement is present and what is necessary to change it. You will just have to accept that without such evidence it is not going to change. Acleron (talk) 07:59, 2 January 2012 (UTC)