Talk:Homeopathy/LEADdiscussion

"Current lead" can be found at Talk:Homeopathy/LEADdiscussion/current lead —Preceding unsigned comment added by Scientizzle (talk • contribs) 16:45, 23 February 2008 (UTC)

Filll's guiding principles for LEAD

My suggestions:

• The LEAD should be as short as possible and simple as possible

• The LEAD should use simple language

• The first paragraph should summarize most of the article.

• The first sentence should say what homeopathy is, as simply as possible.

• The LEAD must include most material of the article in summary form.

• The LEAD must include material describing homeopathy and material critical of homeopathy

• The first paragraph must include material describing homeopathy and material critical of homeopathy.

• The first sentence must include material describing homeopathy and material critical of homeopathy.

• The LEAD, first paragraph and first sentence must describe what is unique and different about homeopathy.

• Details do not belong in the LEAD, and even less in the first paragraph and the first sentence

• The LEAD should be vague. The first paragraph should be more vague. The first sentence should be most vague.

• Comments about how popular homeopathy is in the first few sentences are probably not helpful.

• Comments about how homeopathy is viewed as quackery etc in the first few sentences are probably not helpful

• Comments about how homeopathy violates the known laws of chemistry and physics in the first few sentences are probably not helpful

• Comments describing in detail the opposition of allopaths in the first few sentences are probably not helpful

• Detailed descriptions of potentization, succussion, trituration etc in the first few paragraphs are probably too detailed

• Long unfamiliar words or jargon like potentization, succussion, trituration, miasma, tincture etc in the LEAD are probably too detailed and confusing.

• Discussions of double blind studies in the first paragraph are probably too detailed.

• The word "controversial" is succinct, accurate and is descriptive, and is not excessively critical by itself.

• Hahnemann is an important figure, but he does not need to be in the first sentence or two, and his relationship to homeopathy should be described carefully but without a lot of detail

• Maybe the word "dilution" is too controversial to use in the first paragraph

• We should compare the homeopathy descriptions from other sources like other dictionaries etc --Filll (talk) 19:12, 8 February 2008 (UTC)

Filll's suggestion 1 for LEAD

First, the first paragraph:

Homeopathy (also homœopathy or homoeopathy; from the Greek ὅμοιος, hómoios, "similar" + πάθος, páthos, "suffering" or "disease") is a controversial form of alternative medicine. Homeopaths often advocate remedies which contain very small quantities of substances that, at higher doses, could be expected to produce symptoms of the disease being treated. Many people in some areas use homeopathy. German physician Samuel Hahnemann is commonly regarded as the father of homeopathy, having done substantial work to establish the concepts in the 18th century.

--Filll (talk) 19:30, 8 February 2008 (UTC)

OK this is FINE! But the sentence 'many people in some areas' sounds a bit awkward, maybe it can be improved such as 'Homeopathy is a popular form of medicine in some areas and not at all in others?' Without giving examples it is vague, which is what you said you want, but what do you want this entence to convey to the reader? am I reading it wrong? thanks Peter morrell 20:13, 8 February 2008 (UTC)

Ok fair enough. That is a first attempt. I want to talk about how it is popular among some groups and in some parts of the world (like India, and maybe some places in Europe), but less popular in other areas (seems to be of decreasing interest in the US over the last 100 years).--Filll (talk) 20:25, 8 February 2008 (UTC)

OK so why not say this 'homeopathy is in common use in countries like India and Pakistan, in fairly commonly use in Europe, but has hardly any presence at all in the USA?' how does that sound or a variant of that? Peter morrell 20:32, 8 February 2008 (UTC)

I disagree (again) with putting "controversial" (or "popular") in the first sentence

or at least in the first clause, for the reasons I've already stated. It's placement, per se, in the first sentence would not be NPOV; this sentence has special significance, and, given that this is not normal reference-work practice, gives the controversy surrounding homeopathy special significance that WP normally shuns.

I again would support RDOlivaw's version, at least as a starting point:

Homeopathy (also spelled homœopathy and homoeopathy), from the Greek ὅμοιος, hómoios, "similar" + πάθος, páthos, "suffering" or "disease", is a method of treating disease based on the idea that a substance which causes symptoms similar to a disease can, often highly diluted and potentized, be a remedy for that disease. Homeopathy was first defined by German physician Samuel Hahnemann in the late 18th century, and is a common form of alternative medicine. The value of homeopathy is controversial, as it lacks any apparent basis in scientific theory, and no clear experimental evidence has emerged supporting its usefulness beyond the placebo effect.

Friarslantern (talk) 20:54, 8 February 2008 (UTC)

I can see both points on this. So should you say it's controversial or say it's controversial and say why? You seem to say the latter. It is a fine point. If you are to say it is controversial at all, then you also need to state why immediately, or leave the controversy until later. One hopes that this type of fine hairsplitting will also be reflected elsewhere on much weightier matters e.g. concerning efficacy. thanks Peter morrell 21:33, 8 February 2008 (UTC)

Allow me to make a few comments:

• I disagree (again) with putting "controversial" (or "popular") in the first sentence

or at least in the first clause, for the reasons I've already stated. It's placement, per se, in the first sentence would not be NPOV

I think there is some confusion about what NPOV means. NPOV is not neutral. NPOV is not uncritical. NPOV is closer to "mainstream view". And the mainstream view of a medical treatment is the view that most allopathic doctors would have of the procedure, particularly those in research organizations. So one word "controversial" is fine, because we will discuss the controversy in the article, or should. And the LEAD must summarize what the article contains. Simple as ABC. It must be that way.

I do not advocate going into big discussion of how it is controversial or in what way etc in the first paragraph. That can wait to the 3rd paragraph or so of the LEAD.

• this sentence has special significance, and, given that this is not normal reference-work practice, gives the controversy surrounding homeopathy special significance that WP normally shuns.

Huh? How does WP shun controversy? Have you read intelligent design? Creationism? Any of literally thousands of articles on controversial subjects on Wikipedia? NPOV itself dictates that the controversy must be prominent and upfront. More so than normal reference works.

• I again would support RDOlivaw's version, at least as a starting point: Homeopathy (also spelled homœopathy and homoeopathy), from the Greek ὅμοιος, hómoios, "similar" + πάθος, páthos, "suffering" or "disease", is a method of treating disease based on the idea that a substance which causes symptoms similar to a disease can, often highly diluted and potentized, be a remedy for that disease.

The word "potentized is too hard for the first sentence, and the first paragraph and probably the LEAD as well. This is even worse when it is undefined, and is a highly uncommon word. Hardly a single reader will have a clue what this sentence means. More than that, the word "diluted" is a bit complicated because not all remedies are diluted. And homeopaths do not like to think they are diluting the more potent remedies by the procedure; that is the mainstream interpretation. Also this sentence structure is complicated and awkward.

• Homeopathy was first defined by German physician Samuel Hahnemann in the late 18th century, and is a common form of alternative medicine.

My understanding is that Hahnemann's work on homeopathy and its foundations went on for a few decades, and the concepts changed over that period. I am also uncomfortable with the word "defined" because of all the precursors of all the parts: the law of similars, the succussion, the serial dilution, etc. I guess it is true that Hahnemann picked the name "homeopathy". But I think that is not what he is noted for, mostly.

• The value of homeopathy is controversial, as it lacks any apparent basis in scientific theory, and no clear experimental evidence has emerged supporting its usefulness beyond the placebo effect.

Again that is a lot to swallow in the first paragraph. The average reader will not know what the placebo effect is. This is also a long sentence with a complicated sentence structure. I think that the description of why it is controversial should be left to the later paragraphs of the LEAD.

I think that the first paragraph should be as simple as possible, and as accessible as possible, with no large words, and no specialized jargon. Then later paragraphs can be more complicated and introduce more complicated concepts. --Filll (talk) 23:00, 8 February 2008 (UTC)

• Homeopaths do not speak of treating "diseases", so that wording is inaccurate.
• I would suggest changing "The value of homeopathy is controversial, as it lacks any apparent basis in scientific theory, and no clear experimental evidence has emerged supporting its usefulness beyond the placebo effect." to

Homeopathy is controversial, as it lacks any apparent basis in mainstream science, and no consistent experimental evidence has emerged supporting its efficacy. Despite this, many consumers, pharmacists, physicians, and other health care providers continue to use or practice homeopathic medicine and advocate its safety and efficacy.

Arion 3x3 (talk) 14:06, 9 February 2008 (UTC)

Strictly speaking homeopaths do not speak of diseases, they speak of sick persons, that is correct. And conceptually homeopathy rejects the notion of disease as an entity that invades a person and sets up its stall, as it were, which is more or less the mainstream view. However, in ordinary parlance homeopaths do refer to disease as a generic term meaning simply 'a sick person,' someone who is unwell. So this is a tricky one if we wish to be in-line with common parlance OR pedantic as per homeopathic conceptuality. Which do we want? I suspect the former rather than the latter. Peter morrell 14:14, 9 February 2008 (UTC)

LEAD PARAGRAPH draft: Arion version 3 - taking into account views stated above

Leads are supposed to be concise. I believe a simple and well written one paragraph lead - instead of 3 paragraphs - is sufficient, as long as all major elements of the article are included in that lead paragraph. Incorporating suggestions and comments from Filll, Peter morrell, and Friarslantern, as well as the Five Wikipedia Core Polices, here is my suggestion:

Homeopathy (also homœopathy or homoeopathy; from the Greek ὅμοιος, hómoios, "similar" + πάθος, páthos, "suffering" or "disease") was developed by Samuel Hahnemann in the late 18th century. It is a system of therapeutics that is based on the "Principle of Similars" or "like cures like". This principle states that a remedy can elicit a healing response in a sick person if it produces symptoms similar to those of that illness in a healthy person. Homeopathic medicines are usually made from naturally occurring plant, animal, or mineral substances. These are administered either in small full strength doses from sources such as plant tinctures, or are "potentized" (a process of serial dilution and shaking) in the belief that this transfers the qualities of the substance into the diluent. Homeopathy has been the subject of much debate in the scientific literature with respect to the plausibility and efficacy of homeopathic preparations and practice. Nonetheless, many consumers, pharmacists, physicians, and other health care providers continue to use or practice homeopathic medicine and advocate its safety and efficacy.

I await your comments. Arion 3x3 (talk) 05:34, 10 February 2008 (UTC)

I have no objections to this revised version. It reads fine to me. Peter morrell 08:43, 10 February 2008 (UTC)

I like how this flows -- it's easy to read. I might change the order of the sentence explaining like cures like... I'll see if I can write it the way I think would work better tomorrow morning.... However, I do feel the end of the paragraph seems to downplay the significance and weight of the scientific scepticism about homeopathy, and it should not. Again, will suggest a different version.... tomorrow.... :-) Friarslantern (talk) 10:10, 10 February 2008 (UTC)

I have several problems with it. First, I am not sure it will pass WP:MOS. Second, I think that the first few sentences should be quite accessible. Introducing things like "Law of Similars" and tinctures and potentized are really just not going to fly with a regular audience. We are not writing for homeopaths here. The word remedy is used in a strange way of course, using the homeopath's definition. System of therapeutics is too complicated for the first couple of sentences. The article must have a good measure of mainstream discussion and viewpoint, and the LEAD must summarize that. So at least a third of the LEAD must discuss such matters. And although I think we can live with minimal discussion of it in the first couple of paragraphs except maybe a nod to "controversial", the third paragraph should discuss the mainstream view. --Filll (talk) 14:02, 10 February 2008 (UTC)

I have to agree. There are many FAs with leads of roughly the same size as the current one for Homeopathy; and given the size of the article and the breadth of coverage, a decent-sized lead is appropriate. This version eliminates much of the positives of the current version (decent WEIGHT distribution, limited jargon, etc.) to a more esoteric version that especially lacks any teeth regarding the claims of skeptics. — Scientizzle 17:46, 10 February 2008 (UTC)

I basically have 3 problems with it (1) inaccessible (2) written by homeopaths, for homeopaths (3) no discussion of skeptics position. --Filll (talk) 17:55, 10 February 2008 (UTC)

• I read through 25 different definitions of homeopathy on the Internet - written for "a regular audience" - to assemble my suggested wording. (I entered "What is homeopathy?" into the Advanced Google Search.) Why are Wikipedia readers assumed to be less able to comprehend simple explanations?
• I believe that "much debate in the scientific literature with respect to the plausibility and efficacy of homeopathic preparations and practice" summarizes the existence of controversy. The last 2 sentences are derived from the the Pharmacology article that I have cited at the end [4] (which was not "written by homeopaths, for homeopaths").

• WP:LEAD suggests "briefly" including "notable controversies" in the lead. This is not the place to amass the evidence on one side or the other.

• A number of uninvolved editors who have left comments at the Homeopathy discussion page about the lead section have noted how "peculiar" it was that the lead has a substantial paragraph to push the POV of the medical and scientific establishment on homeopathy, even supporting broad conclusions by lists of refs. The lead is the place to say what the topic is - and that it has sparked "much debate". It is not the place to get into discussion as to who criticizes it and why. Arion 3x3 (talk) 18:06, 10 February 2008 (UTC)

I am not claiming there should be an extensive discussion of the skepticism, criticism or mainstream science and allopathic medical positions. However, I see nothing wrong with two or three sentences, with references. Look at the FA intelligent design. Does it have any discussion of the criticism in the LEAD? It sure does.--Filll (talk) 19:18, 10 February 2008 (UTC)

A selection of definitions

• complementary disease treatment system: a complementary disease-treatment system in which a patient is given minute doses of natural substances that in larger doses would produce symptoms of the disease itself (encarta)
• a system of complementary medicine in which disease is treated by minute doses of natural substances that in large quantities would produce symptoms of the disease. (oxford)
• a system of medical practice that treats a disease especially by the administration of minute doses of a remedy that would in healthy persons produce symptoms similar to those of the disease (Miriam Webster)
• a system of treating diseases in which ill people are given very small amounts of natural substances which, in healthy people, would produce the same effects as the diseases produce (cambridge)
• A system for treating disease based on the administration of minute doses of a drug that in massive amounts produces symptoms in healthy individuals similar to those of the disease itself. (American Heritage)
• the method of treating disease by drugs, given in minute doses, that would produce in a healthy person symptoms similar to those of the disease (opposed to allopathy). (dictionary.com based on Random House)
• homeopathy, system of medicine whose fundamental principle is the law of similars—that like is cured by like. It was first given practical application by Samuel Hahnemann of Leipzig, Germany, in the early 19th cent. and was designated homeopathy to distinguish it from the established school of medicine which he called allopathy. The American Institute of Homeopathy was founded in 1844, and the practice of homeopathy was popularized in the United States by the physician and senator Royal S. Copeland (1868-1938). It had been observed that quinine given to a healthy person causes the same symptoms that malaria does in a person suffering from that disease; therefore quinine became the preferred treatment in malaria. When a drug was found to produce the same symptoms as did a certain disease, it was then used in very small doses in the treatment of that disease. U.S. medical schools do not presently emphasize the homeopathic approach, although it has become popular among some physicians in European and Asian nations and is widely used by the public in over-the-counter medications.(Columbia Electronic Encyclopedia, in reference.com)
• Bottom Line: Homeopathy is based on principles that are scientifically unsound. Clinical trials have not found any consistent evidence to show that homeopathic medicines work. Homeopathy is a complementary therapy developed by Dr. Samuel Hahnemann, a German physician, about 200 years ago. Promoted as a safer and more holistic approach to disease, it has remained especially popular in European countries and in the United States as well. The word homeopathy derives from the two Greek words Homoios, meaning "similar", and Pathos, meaning "suffering." Homeopaths treat disease using very low concentration preparations. Practitioners select a highly dilute form of substance that would, if given in full strength to a healthy volunteer, cause the presenting symptoms of the patient. Many opponents argue that homepathic medicine is a placebo. A randomized controlled trial of ultramolecular homeopathic formulations showed no observable clinical effects (18). A meta-analysis found the clinical effects of homeopathy to be placebo effects (20). However, other studies using different methodologies found clinical effects cannot be completely attributed to placebo effect alone. One randomized, double-blind clinical trial showed homeopathic medicine can treat the heat of the skin resulting from radiotherapy for breast cancer (19). Another study reported that homeopathic treatment improved symptoms of xerostomia (21). Nonetheless, these results must be viewed with strong caution as the proposed mechanism for homeopathic treatment contradicts modern scientific understanding. Homeopathic products do not agree with basic scientific principles as extreme dilutions contain not a single molecule of the active ingredient. For that same reason, homeopathic remedies are free of toxicity or side effects, except when mainstream care is postponed for serious illnesses such as cancer. While homeopathic remedies may be used for some self-limiting ailments, no published evidence has indicated the use of homeopathy as an effective therapy for cancer. Recent claims of a homeopathic smallpox vaccine have no supporting scientific studies.

Purported Uses

To treat allergies

No scientific evidence supports this use, and clinical trials have produced conflicting results.

To treat anxiety

Scientific evidence and clinical trials do not support this use.

To treat rheumatoid arthritis

No scientific evidence supports this use, and clinical trials have produced conflicting results.

To treat asthma

Scientific evidence and clinical trials do not support this use.

To treat the common cold

No scientific evidence supports this use, and clinical trials have been inconclusive.

To relieve painful and heavy menstrual periods

No scientific evidence supports this use.

To treat disorders of the eye

No scientific evidence supports this use.

To treat hemorrhoids

No scientific evidence supports this use.

To treat warts

No scientific evidence supports this use.

To treat radiotherapy side effects

One study shows homeopathic medicine can reduce the sensation of heat of the skin caused by radiotherapy.

Research Evidence Over 100 clinical trials of homeopathic preparations have been conducted, with overall mixed results. Several studies show positive effects of homeopathic preparations, but there has been controversy as to whether these beneficial effects are truly a product of the medicine, or simply a placebo effect. A placebo effect is defined as an effect brought about by the patient's expectation that something will happen, or the "power of suggestion" (i.e., a person getting better from the psycho-somatic effects of believing that their homeopathic medicine will make them better, not from any activity of the medicine). One study reviewed 89 clinical trials and concluded that, statistically, the positive effects from homeopathy could not be attributed to the placebo effect alone. While another study covered 110 trials found homeopathic medicine is no better than placebo. This debate is far from settled.

Another problem that plagues most clinical trials of homeopathy is that they rely on subjective (reported by the patient), rather than objective (observed by the doctor), measures of effectiveness. Because inter-individual perception, memory, and reporting varies, subjective results are as a rule less reliable.

A clinical trial asked 253 healthy adult subjects to report clinical symptoms after being randomly assigned to take either a very dilute Belladonna treatment or placebo. Laboratory studies found no difference between the two substances. In addition, roughly the same number of people from each group exhibited 'tell-tale' signs of a homeopathic Belladonna treatment. Researchers conclude that very dilute homeopathic remedies have no observable clinical effects.

Warnings Homeopathic remedies are generally free of toxicity or side effects, except when mainstream care is postponed for serious illnesses such as cancer. There is no evidence that homeopathy is an effective therapy for cancer.

Do Not Take If You regularly eat mints, coffee, tea, chocolate, or spicy food

Side Effects None known

Special Point Recent reports of a homeopathic smallpox vaccine are not supported by any laboratory or human studies.

(Sloan Kettering - About Herbs, Botanicals and other products)

• Form of energy medicine (vibrational medicine) developed by German physician Christian Friedrich Samuel Hahnemann (1755-1843), who coined its original name. The major homeopathic theories include five that Hahnemann either hatched, or embraced and expounded (A dictionary of Alternative Medicine).

Discussion

The longer and more complete the article, the more likely it is to discuss the criticism, even in the introduction. The more mainstream science-based dictionary certainly does it. The alternative medical dictionary includes more flaky material which many editors here tried to remove, and also hints that Hahnemann was an important figure, but not the sole figure.--Filll (talk) 19:49, 10 February 2008 (UTC)

It seems to me, Fill, that the above examples you've given argue against labeling homeopathy as "controversial" in the first sentence. While I'm sure all these sources are somewhat dated, they probably aren't so dated as to have been written before homeopathy was considered controversial. The above indicates to me that the basic, essential definition of homeopathy does not include information as to whether it is controversial, or for that matter, popular. I feel this is the standard model of an encyclopedic article, and it seems to me that WP does not want to stray from a standard, mainstream model in its style of presentation or emphasis -- quite the opposite.

On the other hand, of course the controversy, and noting that homeopathy seems implausible and has yielded no clear clinical evidence of its effectiveness, belongs in the lead, and I certainly support you in asserting as much. I would agree that some editors of this article have tried to write a lead which makes homeopathy sound much rosier than it should, and assert that many editors here have re-written the lead to make it sound much more suspect than it should. Friarslantern (talk) 18:19, 11 February 2008 (UTC)

You are partly correct, and agrees with what I said. A one sentence description is unlikely to include anything negative. A longer description, particularly the science-oriented article, is far more negative than anything that has been proposed for WP. So what we are proposing is not as negative as some, and not as uncritical as some. Which is as it should be.--Filll (talk) 18:37, 11 February 2008 (UTC)

Notes & references

References & Notes