Talk:Traditional Chinese medicine

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Removing medical jargon

According to the manual of style for medical articles, medical jargon should be avoided because encyclopedia articles are written for the general public not medical people talking to each other. So, most often the language in the reference material needs to be switched to general language. And health care professionals need to be aware of their habit of using the language carried over from their work or schooling, and switch to general language when they write articles on Wikipedia. See Writing for the wrong audience. Also, articles should not be written as patient teaching materials--as if addressing patients. That is the reason that I reworded the article switching patient to people/person, and other minor changes of wording. My understanding is that these types of rewordings are non-controversial here on Wikipedia. Sydney Poore/FloNight♥♥♥♥ 13:28, 9 April 2014 (UTC)

Thank you for explaining, FloNight. Seems like a valuable principle to keep in mind, but I'm not sure "patient" counts as jargon. A lot of new vocabulary is introduced to the general reader in this article, I think as long as its clear the article is introducing and defining new terms its ok, we just can't assume the reader understands the technical jargon to begin with.Herbxue (talk) 18:15, 9 April 2014 (UTC)

I'm sorry but I disagree that we should be adding this particular terminology that is widely used by medical personnel when speaking to each other in healthcare but not widely used by ordinary people when discussing illnesses and treatments. "Patient" is jargon that medical personnel use when speaking of their clients and customers. It is not a word that ordinary people use when speaking of themselves in or out of a healthcare setting. Since the material is not specifically written for medical personal or patients I don't think that it is desirable to use that wording when speaking of people in Wikipedia articles. Beyond being unnecessarily, it denotes a mentality of ownership of healthcare topics by healthcare personnel that is undesirable in collaborative projects like Wikipedia where the end product benefits from the scrutiny of a variety of sub-populations of people interested in the topic.

My background in healthcare is an OB/GYN Registered Nurse (dating back to the 1970s) who specialized in working with women with high risk pregnancies and pregnancy loss. Through my work with these mother, babies, and their families and friends, I came to see the value of eliminating unnecessary jargon from my language. It is not a matter of "dumbing down" information by substituting a less appropriate word. It is recognizing that the consumers of health information on Wikipedia are not best thought of as clients and customers of medical personnel. But instead people living with a medial condition, their family, friends, neighbors, and employers, and well as students and the intellectually curious reader.

All that said, I normally remove unnecessary medical jargon in articles about diseases and treatments when I see it, and skip over them when the article is about a medical discipline. Not because I don't think alternative wording is better, but often I don't think that is seems as inappropriate. I went ahead and made the changes in this article because I felt it seemed appropriate to do it. A judgment call on my part. My usual practice on Wikipedia is that I don't ordinarily do any reverts when someone objects (unless I'm doing it in my capacity as an oversighter or checkuser based on strict policy.) So, I'm going to leave the article as you reverted it. If someone else sees that value of making the changes then they can do it. Happy editing :-) Sydney Poore/FloNight♥♥♥♥ 14:34, 10 April 2014 (UTC)

Thanks again for the thorough explanation. I am certainly interested in the idea that the words or attitudes used in the article represent "ownership" by one group over another. NPOV can be tricky because the fundamental assumptions of each editor come out not only in the way we word things, but more importantly the basic questions we have that lead to fleshing out the article. Herbxue (talk) 18:06, 12 April 2014 (UTC)

You think Traditional Chinese medicine treats patients? QuackGuru (talk) 18:17, 12 April 2014 (UTC)

You troll much? But seriously, you are not asking me a serious question, are you?Herbxue (talk) 05:39, 13 April 2014 (UTC)

Inappropriate conclusion in lede of article

The end of the lede currently concludes that although TCM has some proponents, it is largely "irrational pseudoscience". This statement is problematic for several reasons.

1. The source for the statement is a 7 year old opinion piece. THe problem is not so much the age of the source, but the fact that one opinion is given the privilege of making the definitive value statement of the article (the last sentence of the lede).

2. The article should not be making a definitive value statement. The statement is certainly a notable and wide-spread OPINION, but it must be stated in the article WHO expressed this opinion. If not, it suggests that WP has collectively concluded that this opinion is fact. We have not.

3. Both words "irrational" and "pseudoscience" are intentionally pejorative terms - they do not add anything to the readers understanding of the issues involved, they are simply insults. If you want the reader to understand the lack of confirmation of TCM ideas by science, you can do so by simply citing the results of systematic reviews (which is what we have to do to justify a positive statement in WP med-related articles). If you don't do this, you are giving an opinion here, but presenting it as if it were fact. That is inappropriate. Herbxue (talk) 06:59, 13 April 2014 (UTC)

Criticism needs to be included in the lede, and since TCM is fringe this needs to be made plain according to policy. Nature seems a fine source for such a claim, and age does not matter unless there's evidence TCM has lost its pseudoscience. Of recent interest here is Jimbo's statement on this subject: see Wikipedia:Lunatic charlatans. Alexbrn ^{talk|contribs|COI} 07:09, 13 April 2014 (UTC)

I fully agree that criticism needs to be included, but an opinion piece in Nature does not constitute a fact that must be disproven (as you suggest), it is just an opinion. Your use of terms like fringe, pseudoscience, and lunatic charlatans shows that you are more interested in POV pushing than an honest appraisal of facts. You seem to take "Jimbo"'s POV to mean that WP policy is to push an anti-fringe POV - that is not what he said, he said some sources are reliable and others aren't. Herbxue (talk) 08:01, 13 April 2014 (UTC)

Best to avoid ranting and personal attacks: you're pulling quite a few of the tactics outlined in WP:FLAT. TCM is obviously based on pseudoscience (meridians, anybody?) and that fringeiness needs to be abundantly clear in the lede according to our policy. Alexbrn ^{talk|contribs|COI} 08:36, 13 April 2014 (UTC)

The only thing that's obvious is that using pejorative labels is controversial, as seen in the lengthy dialogue about use of the term pseudoscience in previous talk page conversations (of which I was not the main person arguing against using the term). So, to say its obvious the article should conclude with a value judgement about an entire medical system is nonsense. This is an encyclopedia, not "Consumer Reports". Show, don't tell. Herbxue (talk) 15:18, 13 April 2014 (UTC)

Are you referring to the category discussion? Whether we use the pseudoscience category is a different question (on which I have no firm view). However, saying TCM is "largely irrational pseudoscience" (which the Nature piece says is "obvious") is fine - and not the least bit controversial, I'd have thought. Is there any serious dispute over the statement? Alexbrn ^{talk|contribs|COI} 15:26, 13 April 2014 (UTC)

Yes, there is. Its fine to include as long as you clearly identify, in the body of the text, who is expressing that it is irrational pseudoscience. As it is written, it implies that WP editors have come to consensus that TCM is irrational pseudoscience. We have not, but even if we did it would be Original Research to express it in this way, thus a violation of guidelines. If the statement is changed to clearly assign ownership of that opinion / conclusion, then I have no problem with it. As it is, it is inappropriate. Herbxue (talk) 05:12, 14 April 2014 (UTC)

So that would be a WP:FLAT No 3? – "You must not say 'the earth is not flat' but 'according to critics of the flat-earth theory, the earth is not flat'". Needlessly attributing uncontroversial statements risks creating the appearance of doubt or disagreement where there is none. Alexbrn ^{talk|contribs|COI} 05:23, 14 April 2014 (UTC)

That's a dismissal on your part, not a sincere engagement with the issue. The "earth is not flat" is not equivalent here. MIllions of people consider TCM to be a valuable system of medicine, don't dismiss them unless you really know them (many are accomplished scientists). I assure you, the statement is controversial and disputable. You are smart enough to know that the article as written makes a conclusion that represents an opinion, and I have made clear that I am not interested in censoring out that opinion, only in making sure it is properly attributed. Herbxue (talk) 06:05, 14 April 2014 (UTC)

Ha! By swaying to popular misconception we'd be in trouble with our UFO, creationist, homeopathy, etc. articles too! TCM is essentially a medieval pre-scientific belief system that has no correspondence with real science. No serious source disputes that. It's just an obvious fact which we can, and should, assert. You have provided no sources for your argument, merely: assertions (that the statement is controversial), an argumentum ad populum and a personal attack. Alexbrn ^{talk|contribs|COI} 06:19, 14 April 2014 (UTC)

"We" could if we had consensus, and we don't. Simply agree to attribute the quote to its source and you would be doing the honorable and scientific thing to do. Instead you just make comparisons to other, more marginalized subjects. TCM may not be mainstream, but it is not "fringe" - there is licensure in many countries and universities dedicated to the subject in Asia and accredited colleges in the U.S. There are many convergences between TCM treatments and scientifically-verified actions of substances, so your dismissal that there is "no correspondence with real science" just shows your ignorance of the subject. If you do not understand the subject, how can you determine what an "obvious" judgement of its merits is? You cannot - you are only presenting an opinion. Herbxue (talk) 06:51, 14 April 2014 (UTC)

I merely echo the mainstream, expert sources. Again, your arguments are of no use here. TCM is licensed in some countries ... so? Homeopathy is available from the National Health Service - that doesn't mean it's science. To repeat: "Needlessly attributing uncontroversial statements risks creating the appearance of doubt or disagreement where there is none". Show me the sources. Alexbrn ^{talk|contribs|COI} 07:42, 14 April 2014 (UTC)

There are many sources stating that TCM is "pseudoscience". The question should be: "Why is there only one reference calling TCM pseudoscience?" Practitioners call TCM "science", yet the practitioners don't seem to perform scientific studies, so it passes the WP:DUCK test. I.e. pseudoscience. Given all of the points @Alexbrn: has made here, the "honorable" and "scientific" thing to do here is to call it Fringe and Pseudoscience. @Herbxue: your behaviour here is bordering on a personal attack. Please focus on content. Jim1138 (talk) 07:35, 14 April 2014 (UTC)

The Joseph Needham source (currently in further reading) has some good content that can be used to expand the article explaining the disjunction between TCM and science. I hope to have time to get round to this shortly (unless somebody beats me to it!). Alexbrn ^{talk|contribs|COI} 07:44, 14 April 2014 (UTC)

I respectfully disagree Jim. Practitioners generally do not call TCM science, and yet often do participate in scientific studies. I have personally conducted a pilot study on a topical herbal preparation, and have the highest respect for those that conduct serious research as a career. Alexbrn gets under my skin because he defended POV-pushing edits by Dominusvobisdu that misrepresented Ernst's conclusions regarding placebo effect, and thus has a history of preferring his opinion over facts. That should not cloud the real issue here - labeling a system of thought that is pre-scientific and that does not claim to be based on science "pseudoscience" is an expression of opinion, not fact. It may be a popular opinion, it may even be the MOST popular opinion, but that does not make it fact. An opinion should be attributed to those who express it in the body of an article. Alex, I fully welcome your contributions about the "disjunction between TCM and science", I have no problem with that line of thinking. Herbxue (talk) 07:56, 14 April 2014 (UTC)

An appeal to personal experience and more personalization. If the statement is not in serious dispute (i.e. in high-quality sources) then it's a fact we can just assert. Failing to do so would not be neutral. Alexbrn ^{talk|contribs|COI} 08:01, 14 April 2014 (UTC)

We've gotten circular at this point, need input from others.Herbxue (talk) 15:16, 14 April 2014 (UTC)

Looks to me like there's no consensus for your proposed change. Alexbrn ^{talk|contribs|COI} 15:19, 14 April 2014 (UTC)

Not yet at least.Herbxue (talk) 21:29, 14 April 2014 (UTC)

I don't feel comfortable with putting "pseudoscience" in the lede, for various reasons.

1.) I think TCM's theoretical base is largely superstitious, but "pseudoscience" implies that TCM actually tries to sound scientific. Which it doesn't. It has used the same terms since 2000 years.

2.) The source we have now is stating nothing else but the opinion of the author of the article, so the source could actually only be used for a sentence like: "An editorial in Nature stated that..."

3.) Apart from "pseudoscience", TCM has also been labeled "proto-science"[1] and "pre-scientific"[2] (and probably a couple of other terms as well that didn't show up on my google search).

My suggestion would be to either to not include all this labeling (and I actually don't understand the necessity for it) or to keep all these sources in a sentence like "TCM has been labeled pseudoscience, proto-science..." etc. --Mallexikon (talk) 10:33, 17 April 2014 (UTC)

i agree with above suggestion. 93.86.155.2 (talk) 15:55, 18 April 2014 (UTC)

Comment: calling TCL fringe is beyond ridiculous... Billion+ people in Asia turn to this instead of modern medicine. In fact, one could say modern medicine is fringe for Asians. 93.86.155.2 (talk) 15:43, 18 April 2014 (UTC)

Point taken. However, from a scientific worldview (and that's what we follow on WP), it would still be considered fringe. --Mallexikon (talk) 01:50, 20 April 2014 (UTC)

One controversial descriptor at a time, please :). Looks like there is sufficient doubt that "irrational pseudoscience" is a consensus-driven conclusion here. Again, I am not trying to edit out that opinion, but we as WP have not concluded that TCM, without a doubt, deserves to be labeled as such. I will make a neutral edit now.Herbxue (talk) 06:18, 20 April 2014 (UTC)

QG reverted my neutral edit as OR, so I just changed the (overly) close paraphrase to a quote (it was basically a quote already, though someone slipped the word "irrational" in for extra flavor, not from the source). Herbxue (talk) 14:44, 22 April 2014 (UTC)

How about a sentence in the form of: "TCM has been both been labeled a protoscience(citation) and a pseudoscience(citation)"...? --Mallexikon (talk) 06:04, 23 April 2014 (UTC)

"TCM has been both been labeled a protoscience(citation) and a pseudoscience(citation)" is engaging in original research. QuackGuru (talk) 06:10, 23 April 2014 (UTC)

Let's not get pointy. Of course, we could split the sentence: "TCM has been labeled a protoscience(citation). TCM has been labeled a pseudoscience(citation)." But that would sound imbecile, no? And we're here to build an encyclopaedia with good articles, no? --Mallexikon (talk) 07:55, 23 April 2014 (UTC)

"From the standpoint of Cognitive Science, Chinese Medicine appears as a proto-scientific system of health observances and practices based on a symptomological classification of disease using two elementary dynamical-processes pattern categorization schemas: a hierarchical and combinatorial inhibiting-activating model (Yin-Yang), and a non-hierarchical and associative five-parameter semantic network (5-Elements/Agents)."(PMID 17965759) That is nonsense.

"TCM has been labeled a protoscience(failed verification). TCM has been labeled a pseudoscience(failed verification)." QuackGuru (talk) 17:32, 23 April 2014 (UTC)

Not quite clear what you're trying to say. --Mallexikon (talk) 01:37, 24 April 2014 (UTC)

The source does not say "TCM has been labeled a protoscience".(PMID 17965759)

"TCM has been labeled a pseudoscience" is OR and does not tell the reader anything. I call it diluting the facts. QuackGuru (talk) 06:18, 24 April 2014 (UTC)

The source says "proto-scientific system". If you'd like to claim that that is not covered by WP:Close paraphrasing, I'll be happy to go into WP:DR about this. A third-party opinion might be a good starting point. --Mallexikon (talk) 09:05, 24 April 2014 (UTC)

The source written by the trade fails WP:FRIND for such an extreme view. We have independent sourcing for pseudoscience. You can't obscure the facts with the bias source. QuackGuru (talk) 19:46, 24 April 2014 (UTC)

The source, a peer-reviewed journal, is reliable. If that is a "trade" journal, then so is any journal publishing pharmaceutical research. Herbxue (talk) 19:50, 24 April 2014 (UTC)

Take the source to the noticeboard if you still disagree. See Wikipedia:Fringe theories/Noticeboard/Archive 40#Evidence-based Complementary and Alternative Medicine for previous WP:CON. QuackGuru (talk) 19:54, 24 April 2014 (UTC)

The source is from a peer-reviewed scientific journal. It would take more than a couple editor's opinions to convince me that it is a fringe source. With one editorial calling TCM pseudoscience and an article calling it protoscience, it is clear that there are differences of opinion as to what label it should have, and none of the sources include what the profession itself would label itself as. With all this diversity, the article should certainly not make an OR conclusion that it is pseudoscience. I'd be fine with both labels being included, clearly attributed to the authors asserting the label.Herbxue (talk) 20:41, 24 April 2014 (UTC)

For now we should abide by WP:CON. You are free to start another discussion about the source at Wikipedia:Fringe theories/Noticeboard. QuackGuru (talk) 20:58, 24 April 2014 (UTC)

Ok, well we have multiple editors agreeing that pseudoscience is not appropriate for the lede so I will abide by WP:CON and remove the whole sentence.Herbxue (talk) 21:00, 24 April 2014 (UTC)

Not only pseudoscience label is inappropriate, but talking about TCM in context of fringe and similar guidelines is even more inappropriate. I don't think some editors here understand what fringe means. Even the cited guideline explains something different, read the nutshell if nothing further... 178.221.90.250 (talk) 10:49, 25 April 2014 (UTC)

This has been hashed out a number of times before. I would recommend reviewing the archives

Pseudoscience is appropriate. Besides the cite, it fits the wp:duck test. Many claim it to be scientific, yet fails to use scientific methodology. Many mechanisms of effect are not testable or fail testing. The Pseudoscience label should stay. Consensus has not been reached. Jim1138 (talk) 02:52, 26 April 2014 (UTC)

Archives yield this: https://en.wikipedia.org/wiki/Talk:Traditional_Chinese_medicine/Archive_3#Pseudoscience

I would agree consensus has not been reached - either for or against use of the term pseudoscience, and certainly not for the article concluding it is pseudoscience in the lede. I propose a compromise - simply clearly show, in the text of the article, who asserts that it is pseudoscience. Herbxue (talk) 20:23, 26 April 2014 (UTC)

A summary in the lede for Traditional Chinese medicine#Drug research is appropriate. QuackGuru (talk) 20:28, 26 April 2014 (UTC)

Labels: Pseudoscience, proto-science, pre-science

I added the material about proto-science and pre-science. The source for "proto-science" is a peer-viewed journal; therefore, the formal requirements for WP:RS and WP:FRIND are fulfilled. If someone wants to challenge this source anyway, it would be on them to prove that this source is not reliable even though it is peer-reviewed. --Mallexikon (talk) 01:32, 27 April 2014 (UTC)

See Wikipedia:Fringe theories/Noticeboard/Archive 40#Evidence-based Complementary and Alternative Medicine for previous WP:CON on the source written by the trade. The other misplaced text is from a personal website that is not a summary of Traditional Chinese medicine#Drug research. QuackGuru (talk) 01:38, 27 April 2014 (UTC)

I read Wikipedia:Fringe theories/Noticeboard/Archive 40#Evidence-based Complementary and Alternative Medicine. Nowhere does it say that there's consensus to not use this journal. Please provide evidence if you think this peer-reviewed journal is not reliable. Otherwise please move on. --Mallexikon (talk) 01:53, 27 April 2014 (UTC)

Our lede currently carries the sentence: "Although advocates have argued that research had missed some key features of TCM, such as the subtle interrelationships between ingredients, it has been suspected that the reason for these scarce results is that TCM is largely pseudoscience." IMO, this is too much information for the lede.

I suggest to shorten this sentence to "TCM has also been labeled pseudoscience" and put it behind "It is considered a protoscience, and has been compared to the humoral theory of Galen." --Mallexikon (talk) 04:54, 27 April 2014 (UTC)

I support your suggestion, even though I think the comparison to humoral theory is unfair considering one died out long ago and another has been continually practiced. Still, it is important to contextualize the labels properly and your suggestion is the most appropriate so far.Herbxue (talk) 07:50, 27 April 2014 (UTC)

It isn't protoscience, for the simple reason that current investigations of TCM are characterised by pseudoscience. Earlier (as in prior to Mao's resurrection of the field) investigations are non-science or pre-science or whatever but we reflect current practice in this article, because this article, although it discusses history, describes current practice. The status of TCM inquiry can be assessed by reference to its views on qi and humours: once TCM robustly rejects those ideas as incorrect, we will have some confidence that it has begun a process of proper science. Guy (Help!) 10:08, 27 April 2014 (UTC)

sometimes it is good to trust your eyes. if quantum mechanics can be true, even though nobody understands it, why qi cannot? something being unlikely does not make it impossible. [3][4]. go qi go! 212.200.205.18 (talk) 20:53, 27 April 2014 (UTC)

@Guy: I also think it's a pseudoscience, but your and my opinion doesn't matter. There is no wrong or right reasoning here - it all comes down to different sources calling it this or that. I think it's deplorable to argue about labels here, especially pejorative ones. This article should give an NPOV description of TCM. Adding "it is largely pseudoscience" to the lede definitely doesn't make this a better article, and it adds zero important information for the reader. It just makes it sound like we want to nail our colors to the mast. --Mallexikon (talk) 03:48, 28 April 2014 (UTC)

===Pseudoscience===

For the pseudoscience label, we're currently using this source: "So if traditional Chinese medicine is so great, why hasn't the qualitative study of its outcomes opened the door to a flood of cures? The most obvious answer is that it actually has little to offer: it is largely just pseudoscience, with no rational mechanism of action for most of its therapies." This sentence is a grammatically difficult structure, and I'd like to point out that the colon connects the "it is largely just pseudoscience" with the "the most obvious answer is...". That means, this article is only suspecting that (the reason why success stories like the discovery of Artemisin are so few and far between is that) TCM is a pseudoscience. --Mallexikon (talk) 01:50, 27 April 2014 (UTC)

Feel free to suggest a better wording of that sentence. Guy (Help!) 09:50, 27 April 2014 (UTC)

The suggestion to state only "TCM has also been labeled pseudoscience". in the lede does not tell the reader much. The previous wording added by User:Mallexikon was not an improvement. For example, it has been suspected is weasel wordings to skew/dilute the facts. QuackGuru (talk) 17:00, 27 April 2014 (UTC)

Nope - it is clearer. Anything more is OR. Herbxue (talk) 23:11, 27 April 2014 (UTC)

This source has been correctly reflected in our article's "Drug research" section: "... a 2007 editorial in Nature said that while this may simply be because TCM is largely pseudoscience..."

The sentence featured in our lede ("... it is largely pseudoscience..."), however, is a POV interpretation which is simply not covered by the source. It would either have to be changed or deleted. --Mallexikon (talk) 03:22, 28 April 2014 (UTC)

Looks like an accurate summary of the source to me. It appears that your trying to shift the burden of proof from the TCM side to the science side. The rule in science is that it's bullshit until proven otherwise, and TCM proponents have not offered much in the way of proof. Quite the opposite, in fact. Dominus Vobisdu (talk) 02:05, 29 April 2014 (UTC)

I'm not trying to shift anything. Of course TCM theory is probably bullshit. But we're writing an encyclopaedia here that wants to be better than the Britannica. Throwing around labels like "pseudoscience" is just angry, pubertal POV - Britannica would never do this, unless it's universally excepted. But we don't even have a source saying TCM is universally excepted to be pseudoscience. We only have a source saying "the most probable cause why there haven't been a lot of breakthroughs in isolating new efficient medicaments from TCM herbs is that TCM is largely just pseudoscience". That's not adequate sourcing to put "TCM is pseudoscience" in the lede. So sure, knock yourselves out and satisfy your anger. After all, WP maybe is a place to right big wrongs (like all those soccer moms going crazy about alternative medicine). Why not put "TCM is just pseudoscience" at the top of the lede? Why use a source for this at all, since we have so many smart people on WP agreeing on it? And within no time, WP will look exactly like all of us white male tech/science-friendly geeks like it. Great job. --Mallexikon (talk) 02:36, 29 April 2014 (UTC)

Protoscience

[5]

rest my case 212.200.205.18 (talk) 20:04, 27 April 2014 (UTC)

Once TCM is brought to the standards of modern medicine, it won't be TCM but "medicine". Currently it is not. It seems that few TCM practitioners will agree on fundamental points such as the mechanism of action. Nothing has changed by that declaration, so it is still pseudoscience. Jim1138 (talk) 17:02, 28 April 2014 (UTC)

I also think it's a pseudoscience, but your and my opinion doesn't matter. There is no wrong or right reasoning here - it all comes down to different sources calling it this or that. I think it's deplorable to argue about labels here, especially pejorative ones. This article should give an NPOV description of TCM. Adding "it is largely pseudoscience" to the lede definitely doesn't make this a better article, and it adds zero important information for the reader. It just makes it sound like we want to nail our colors to the mast. --Mallexikon (talk) 01:00, 29 April 2014 (UTC)

The edit did not match the edit summary. You deleted sourced text that is part of the summary of the body. QuackGuru (talk) 01:40, 29 April 2014 (UTC)