Talk:Alternative medicine/Archive 22

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In the midst of all the cross-talk above comes a proposal that the proper use of "conventional" (medicine) in this context is to signify the common practice among physicians (what state medical boards call "usual standard of care") per [[2]]. That sounds about right: any reasoned objections? Can we go on from there? Qexigator (talk) 10:05, 7 January 2013 (UTC)

Errrr, where are the reliable sources for this definition? --Enric Naval (talk) 14:02, 7 January 2013 (UTC)

Good point, EN: with the amount of editors' toing and froing about sources, there must be somewhere which covers this? If not, that itself raises questions. Meantime, the following (in what I take to be a "primary source") seems to cross boundaries for classifying types of medical practice: Now in its 35th year, the Foresight programme has not only helped couples have healthy babies, but has also succeeded in giving thousands of 'infertile' couples the chance to become parents naturally-- in many cases where conventional medicine has failed. This looks odd to me. There seems to be nothing in the programme which is not within what any licensed medical practitioner of 'conventional medicine' could propose to patients. It certainly could not be properly characterised as "voodoo". But the promoters of the programme themselves (Foresight Association For The Promotion Of Pre-Conceptual Care, UK Registered Charity) seem to set themselves apart from conventional medicine. That may be another reason for being wary about overuse of "conventional". I am concerned here only with clarity of communication, given the variety of current usages, and make no judgment about the medical merits of this programme or any other medical regimen. Qexigator (talk) 15:16, 7 January 2013 (UTC)

Yep, good point. If we define alternative as 'not conventional', then what is 'conventional' ? We could use the BMJ review (ref 10) that quotes the Cochrane definition: “Complementary and alternative medicine is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed.". My reading of this is that 'Conventional medicine can be defined as the "modalities, practices and accompanying theories and beliefs" intrinsic to the politically dominant health system.' . The sourcing is near perfect, it's an approachable article in a high impact, high quality, core medical journal, citing an authorative medical body's definition of the subject. The article dismisses a number of 'unhelpful' assumptions about CAM, including that it is 'natural, unscientific, irrational, unproved and harmless'. The section in question is even freely available without a subscription.

The NIH/NCCAM (ref 2) defines it as follows: " Conventional medicine (also called Western or allopathic medicine) is medicine as practiced by holders of M.D. (medical doctor) and D.O. (doctor of osteopathic medicine) degrees and by allied health professionals, such as physical therapists, psychologists, and registered nurses. The boundaries between CAM and conventional medicine are not absolute, and specific CAM practices may, over time, become widely accepted."

Does that help or hinder ?Aspheric (talk) 18:35, 7 January 2013 (UTC)

Will help, unless source naysayers object or if ...broad domain of healing resources... other than those intrinsic to the politically dominant health system of a particular society... is felt to be too truthfully and pragmatically descriptive, and scientifically and academically rational, for any intent on retaining the inappropriate use of "propaganda" and "fraud" in the opening paragraph. Qexigator (talk) 18:53, 7 January 2013 (UTC)

• The "politically dominant health system of this particular society" is a science base, not a supernatuural or a fraud base.

The "politically dominant health system of this particular society" is one based on science, not based on the supernatural or on fraud. Why deliberately mislead the encyclopedia reader by taking words out of context? Why try to make people think somthing false, that Cochrane, BJM, NIH, or WHO believe in the supernatural, when they do not? 71.202.76.76 (talk) 00:59, 9 January 2013 (UTC)

Please explain what you denote by this particular society. Qexigator (talk) 01:19, 9 January 2013 (UTC)

This particlular society is the world in the 20th and 21st century. Believe it or not, science is still dominant politically, despite the marketing onslaught of chiropractors and the such. 71.202.76.76 (talk) 01:44, 9 January 2013 (UTC)

I would say money is dominant, then perhaps science. May I remind Aspheric that he calls the "Cochrane/BMJ" definition is not that, but rather a rather strongly-biased definition that came out of a 1995 definition by an "expert panel" at NIH's "Institute of Alternative Medicine" or IAM (not to be confused with IOM), which was later in 1998 to become NCCAM division of NIH, and is quoted out of context here. All this is in the last archives of this page from 6 weeks ago: [3]. The Cochrane definition of alternative medicine is actually very vague. It's the grant-hungry 1995 OAM (what is now NCCAM) that proposed to define CAM as a bunch of "healing resources." Which OAM/NCCAM, with enough grant money, will be glad to help you sift. They've since backed off that stance, as you can see in the later NIH/NCCAM reference 2 above, one which is far more suitable for this article.

As to "conventional medicine" being defined by various state boards as the "standard of care" by your fellow MD's and DO's, that is more or less tautological. Conventional medicine is what state boards let M.D.'s and D.O.'s get away with. People with ND and DC degrees and even TCM degrees are given more leeway, but they are not considered to be practicing conventional modern (Western) medicine. That is defined by what MD's and DO's normally do.

With that caveat, it is certainly NOT defined by what is "science based". For one thing, it's hard to tell what level of induction supports a practice well-enough to say if it's now "science based". Partly that's why the FDA exists, but the FDA doesn't control and define the bounds of all conventional medical practice in the US (yet). Incidentally, the state licensing board's reliance on "standard of practice" is a very "Wikipedia-like" move that keeps state boards themselves from having to know what is "science based." They don't have to do a job like the FDA's-- all they need to do is look out and see what most physicians do, very much like NPOV vs. "truth" on Wikipedia.

State boards (which don’t have the FDA’s resources) just need to do opinion-polls of current practice standards, and if a physician is within them, he's safe from the licensing boards. He might be wrong, but he's conventional. So, if your doctor in the past prescribed you Rezulin and it destroyed your liver, or Vioxx and it gave you a heart attack, the state board is not going to be interested, because his fellow MD's were all doing the same, science or no. As for the FDA, it is pretty much immune to lawsuits, being a regulatory branch of government. Federal judges don’t like to rule against the FDA, as that’s not good for careers. As a plaintiff you can argue that the FDA is more interested in money than science all you like (since they are mostly funded by pharma fees), but it will get you nowhere.

So, that's what we mean by “conventional,” as referring to social context and not science. If medicine was entirely based on good science, it would hardly ever back-track, or need to. It would add frills and new understanding, as happens in physics and chemistry, but the old ways would still continue, very much as we still teach (for example) Newton’s laws in physics classes, even though we know they aren’t strictly always correct in some situations. I WISH medicine was that way, but I’m here to tell you that it is not. There’s too much guesswork and money involved at the level of “current practice standards,” for that ever to be true. SBHarris 03:41, 9 January 2013 (UTC)

-IP has proposed that science is dominant in the world in the 20th and 21st century. Is there some reliable and relevant source, other than bland assumption, as a basis for this claim about "science", as clearly and unambiguously defined? The remark about "science is still dominant politically" looks like POV and agenda pushing. Qexigator (talk) 10:03, 9 January 2013 (UTC)

--Why is it assumed that "state boards" specifically refers to the member states of the USA federal republic? There are other English language states outside USA (not to mention others, older and younger than USA) which in a general sense have state boards with similar functions. If this article is intended to be USA focussed, that should be made clear in the topic title, for clarity in communicating the information. Qexigator (talk) 10:18, 9 January 2013 (UTC)

Bold face was put in SBHarris' comment. SBHarris, you can change it back, but this particular phrase is key to the endless problems in this article. A small handful of editors (recall agf is not a suicide pact) appear to be deliberately trying to use Wikipedia to commit fraud, that being a deliberate deception that alt med differs from real medicine only in it being unconventional, when in fact it is oten unconventional only because it is not based on science. That is the same basic fraud of snake oil salesemen and any other pseudoscience fraudster. Argument here is pointless, since editors like Pulah and theothers clearly understand what is going on, but perpetually reintroduce the same nonsense as if they are so naive as to believe what they are writing. It is very clear what is going on in this talk page and in the aricle, where Pulah and a few others have destroyed the article body by putting the word "conventional" in so many times that they appear to think that endless repetition will make its own reality like Nazi propoganda discussed in the NYAS article of the lead. agf is not a suicide pact, and it is time to finally put a stop to this pretension to being sincere in believing and arguing for a claim that alt med may be science based, but is just not conventional as what defines it. That is a deliberate lie in the context of the overwhelming number of times this has been refusted to the same handful of editors, but they simply come back and pretend the archived talk pages never existed. Read the NYAS article, which describes this exact process. 64.134.228.26 (talk) 15:49, 9 January 2013 (UTC)

IP 64... proposes "quoted out of context here" is key to the problems in the article, but the rant-like remarks which follow make it difficult to see whether or not that amounts to a reasoned contribution to the discussion. In my view, an inclination to see others as intent on committing fraud is actually one of the key problems. My response to IP 72... in section below also applies. Or is all this a dispute local to USA or N.America? Qexigator (talk) 17:16, 9 January 2013 (UTC)

For the record, I don't think the concept of alternative medicine can be usefully defined as a set of specific practices, except in the "west" or at least the developed world where partly science-based stuff competes with older systems based on religion, ceremonial magic, wishful thinking, and folk tradition. Ayurveda is not alternative in India, and TCM is not alternative in China. I simply want to avoid the trap that assumes all Western medicine is science-based (only half of it is), and that all alternatives are based on paranormal ideas (most are, but not quite all). Herbalism and orthomolecular treatments in particular are not based on paranormal assumptions. They are quite different (or can be in theory) in character from magic or "psychic energy" based treatment. Of course this is confused by the fact that nearly all herbal and folk traditions come with a magical overlay. But this isn't a needed component. SBHarris 18:21, 9 January 2013 (UTC)

--And for the record let me say that, while it is not the whole story, this could be part of the reasoning which may help towards improving the article. It seems likely that in the "west", where there is a predominance of what may more or less be commonly meant by "science based", some of the practices deriving from earlier times or other places may be, somehow or other, efficacious in their own way, and should not be demeaned by reason only of not being "standard practice" under state medical boards. Actually, as a non-specialist, I have the impression that some "standard" medical practices in the not distant past (20c.) would now be regarded with less favour than some of those from other cultural traditions. Qexigator (talk) 19:24, 9 January 2013 (UTC)

• "'evidence-based’ practice is the dominant paradigm" secondary source - Medical Journal of Australia. (ref name in source in article is RRCAM) 24.130.156.204 (talk) 00:51, 13 January 2013 (UTC)

It's a good article, freely available and critiques CAM in an intelligent manner. The 4th paragraph suumarises the problems with CAM definitions nicely and could be used to expand the terminology section. I don't think it provides a definitive answer to the problems outlined above. Particularly since experience and anecdote are part of the Hierarchy of evidence albeit at the bottom.Aspheric (talk) 13:31, 13 January 2013 (UTC)

Per aricle appeal section - "There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies, mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments." This is well sourced, but it is misleading in that -

• Big Pharma bad science fraud and desire to sell drugs to everyone they can, is not a "conspiracy theory". It is a marketing strategy.
• Distrust of surgeons trying to line their pockets under color of scientific authority is not "mistrust of traditional authority figures" - it is rational skepticism, or calling a spade a spade.
• Dislike of the current delivery methods, e.g., find a vague category in DSM and look up the insurance billing code, and get a lifetime of income from an unfalsifiable prescription of antidepressants, with a lifetime get cash reward, is being too nice. It should not be "dislike", it should be "hate".

Perhaps some of the intensity on this debate page would be toned down if those who think this article bashes alt med, when there may be good reason to bash supposedly science based med much more, could have this perspecive be more in the article. But how can this be done without going offtopic? 24.130.156.204 (talk) 00:24, 14 January 2013 (UTC)

You know what would really help the Christianity article? If we sprinkled some Islam bashing throughout. If you think the Jesus story is stupid, you should hear about Muhammad. TippyGoomba (talk) 00:40, 14 January 2013 (UTC)

Some good points are, unfortunately, being lost in what now reads more like a poor piece of uniformative journalism than an encyclopaedic article:

1_Proponents of alternative medicine often use terminology which is loose or ambiguous... to suggest that consistency with science exists when it may not. What evidence is there for this? -- actually don't proponents often maintain the opposite in order to make it distinct from what purports to be narrowly defined as "science based"?

2_The use of "Western medicine" and "Eastern medicine" is to suggest that the difference is not between evidence based medicine and treatments which don't work, but a cultural difference between the Asiatic east and the European west. The proponents of what is here being used to denote" evidence based medicine" themselves often or invariably make the distinction between "Western medicine" and "Eastern medicine" (or similar) either descriptively or to prefer Western over Eastern.

3_The term "alternative" is to suggest that a patient has a choice between effective treatments when there is not. This seems to object to letting patients choose for themselves, after properly presented information, not commercial or government sponsored promotional material or action.

4_The use of the word "conventional" or "mainstream" is to suggest that the difference between alternative medicine and science based medicine is the prevalence of use, rather than lack of a scientific basis of alternative medicine as compared to "conventional" or "mainstream" science based medicine. The point is whether or not there is factually a prevalence of use, like it or not.

5_The use of the term "complimentary" (sic) is to suggest that purported supernatural entergies of alternative medicine can add to or compliment science based medicine. Why is one "purported" and not the other: POV slanted.

In fact, this piece looks as if it is over-reliant on campaigning literature. and in the style of a disciple of a campaigning individual. Qexigator (talk) 13:53, 10 January 2013 (UTC)

Have you read the cited New York Academy of Sciences source? That source is not "campaigning literature". The content is from a reliable source that has been multiply and repeatedly brought up. This source was previously discussed in the talk pages in many different talk page threads. Please see the talk page archives. (Incidentally, if the source was part of a campaign and not a reliable source, it lost that campaign - see prevalence of use section.) 99.127.226.172 (talk) 14:00, 10 January 2013 (UTC)

OK, I understand what you say, but is not the author notable as a (passionately committed) campaigner? That's my point. Qexigator (talk) 14:14, 10 January 2013 (UTC)

Where does the source discuss "campaigning" of the author? I am not sure I am following this thread. 64.134.228.26 (talk) 15:13, 10 January 2013 (UTC)

Wallace Sampson,[4] Scientific Review of Alternative Medicine, Skeptic's Toolbox, Acupuncture, --Qexigator (talk) 15:48, 10 January 2013 (UTC)

I am still not sure I follow. It looks like you saying the author is a "campaigner" for increased science awareness, like Carl Sagan or others in the media promoting more science education? What does that have to do with the source. Apologies if I am missing something that should be obvious, but I still don't follow. 64.134.228.26 (talk) 17:18, 10 January 2013 (UTC)

Surely it's not that difficult: the source is the author; the author is WS; WS is a passionate campaigner (fair enough and wish him well so far as he means well and does well: the public need such advocates); but a passionate campaigner in the honourable pursuit of his cause may use persuasive language which is not so well suited to an encyclopaedic text, or which may result in undue slant in paraphrase. Qexigator (talk) 18:30, 10 January 2013 (UTC)

It appears from online sources that he is currently special advisor to the attorney general and numerous district attorneys on cancer treatment fraud. I don't see anything about campaigning for anything, or passion over anything. The language in the NYAS article is scholarly and argued for, and the article is highly cited, and so influenced many other scholarly articles. Maybe your point is obvious and I have some kind of blind spot so can't see it. 64.134.228.26 (talk) 18:52, 10 January 2013 (UTC)

Well and good, I know not the man or his credentials, but I have seen the links given above, and where I come from the fact that an expert is retained by a government promoting a controversial healthcare programme (so I hear, not my country) is enough to put any editor on notice of possible advocacy slant, whether he be of the calibre of Sagan or Feynman (who certainly was wise to the uncertainties of molecular and particle physics). The extent of influence is not necessarily the measure of good science. But let that be, more to the present point is: if you can respond to the questions 1-5 above to further improve the text, I shall be glad to know. Qexigator (talk) 20:53, 10 January 2013 (UTC)

He chaired the California board on cancer fraud, and he was one of the main advisors on medical fraud to the Calif AG and numerous county DAs. Likely some of the hundreds of fraudsters put in prison because of his expert testimony over many years, or general alt med practitioners who got shut down as a result of what you call "campaigning", but what others call "expert medical testimony in major fraud actions" in the courts, would not be among his biggest fans, including if any of them ended up as WP editors. Now I am off to my yoga class (no kidding. It may not have efficacy in some healing areas it claims, but it seems to have efficacy in creating an addiction to needig to stretch, and to going to its classes). 64.134.225.194 (talk) 15:39, 14 January 2013 (UTC)

Lots of ideas but lets stay focused on the lead. It's a little ambitious to rewrite the whole article in one go. The NYAS article may well be a useful source for the parts of the article but it is narrative review within a non-medical journal with a low 'impact factor' and is a poor choice to define the topic. We have introductory reviews from core journals, classification papers that focus specifically on terminology and position statements authoritative medical bodies that do a better job of this. The consistent point that they all make is that alternative medicine is defined as 'not being conventional'. Defining therapies as 'proven and unproven' has been suggested but is a minority view. The same is true for classifying them 'scientific and non-scientific'. These themes and ideas are discussed clearly and unambiguously within the medical literature but are not reflected in the current lead. The wider topic is interesting with lots of room for debate but defining the issues should not be a point of contention. It is not debated within the medical literature. Lets keep focused on the lead. Any more comments on the changes proposed in section 'Cochrane Reviews' above ?Aspheric (talk) 20:59, 10 January 2013 (UTC)

Please don't bring up discussion about the lead in a discussion of the terminology section. The reason is that there is a relevant talk page section above, and the talk page sections are to discuss the topic in the section header. It makes it hard to read the topic of discussion because one has to filter through material repeated from above. Thanks. 24.130.156.204 (talk) 22:42, 10 January 2013 (UTC)

No problem, the point regarding NYAS remainsAspheric (talk) 18:49, 11 January 2013 (UTC)

Above comments are relevant for both lead and terminology sectionsAspheric (talk) 18:59, 14 January 2013 (UTC)

The criticism content on the "Marketing" requirement in chiropractic medical training, the history of that medial training requirement, and the anlysis of its effects, as well as the multiple reilable sources for that content, was removed from this article, from the chiropractic article, and from the chiropractic education article. Does anyone know anything of the history of removing this content and sources, including which editors removed it, and the justification, if any? 64.134.225.194 (talk) 16:17, 14 January 2013 (UTC)

Re- "Many alternative therapies have been tested and certain CAM interventions do have evidence"

The example cited is that there is some effect for something in St. John's Wort, which may or may not be what it is traditionally used for, since he source does not specify. This is massively UNDUE to be in the article, and it is very misleading to the reader as a result. The overwhelming commentary, even by supporters of some treatments such as testing some specific traditional herbs, e.g., as antibacerials, agree that most alternative medicine is based on religion nd supernatural beliefs, and does not work at all. If most does not work, then the opening sentence of the efficacy section should not lead a reader to the opposite conclusion. 64.134.225.194 (talk) 17:22, 14 January 2013 (UTC)

Multiple top tier sources describe testing and research of altenative therapies. Danish cochrane group list and categorise therapies according to level of evidence [[5]]]Aspheric (talk) 18:38, 14 January 2013 (UTC)

I undid this edit both as changing from plain English to jargon, and because it is incorrect.

• Evidence based medicine is not based on a theory of opposites as stated - "concepts of treatment'by opposite' are similar to Western "allopathic" medicine". The Non Plain English, jargony "western allopathic medicine", i.e., science based medicine, does not work under a theory of treatment by opposites. It is based on use of the scientific method. Homeopathy is based on a (incorrect) theory of opposites.

• "Psyche" was the ancient Greek word for Greek ideas about the soul, and is not the basis of the supernatural qi energy of TCM and acupunture, nor does it have anything to do with the meridians of acupuncture, which is based on Chinese Astrological considerations (365 days a year), and the number of rivers believed to flow through an ancient Chinese Kingdom (12), and the Chinese numerology that ties it all together. Please see numerology article sub section on Chinese numerology and TCM. 64.134.225.194 (talk) 20:16, 14 January 2013 (UTC)

No problem, i've ammended the text to improve clarity. I've detailed the sources below.

Originally sentence provided an odd description of the source material. Purpose of edit was to correct this. I would recommend either changing the sentence or changing the source. [[6]] Homeopathy is based on 'like cures like', it's originator (Hahnemann) created the term 'allopathic' medicine to describe the opposite cures disease. This term is now used by some as a synonym 'Western medicine'.

Yeah, you're right the term psyche is confusing so i've removed it but i've changed the source on 'Qi' from some dodgy self help book to an academic text with a freely available previewAspheric (talk) 20:59, 14 January 2013 (UTC)

Stick strictly to the reliable sources is best, whether or not you like what they say. You might find that, after thoroughly reading the sources, and sticking to what they say when making edits, and not trying to hunt down a source to fit your own views, that your own views might change into alignment with the sources more naturally than trying interpret sources into alignment with your own fixed views. See WP:Enemy. That is one of the most useful WP policy/guideline/essays I have found, and the wisdom in it even transfers off Wiki, almost like WP:AGF. 24.130.156.204 (talk) 03:46, 15 January 2013 (UTC)

Thank you for your suggestion. I think the article has been badly damaged by a poor source selection, misreading of high quality sources and selective citation. All my edits have been an attempt to correct these problems and so I was very surprised by your comments but have assumed they were made in good faith. The tone and content of the current article has departed widely from medical and lay reviews of the topic and now describes a position that even critical sources (e.g. MJA) describe as 'radical'. My own personal views are in alignment with "conventional evidence based medicine" so in effect I have been writing for the enemy all along. I do however recognise that there is evidence for a minority of unconventional therapies and I also believe that some people just need a kind smile, a cup of tea and a needle in the arm. If an acupunctarist can safely identify these patients and do a better job then so be it.

I have been aiming for neutral edits but have made edits that could be considered both pro and anti alternative medicine [7]. All my edits have been reverted within a few minutes, normally by ip editors. I think the talk page is becoming very difficult to navigate and would respectfully note that WP:TALK states that editors names should not be included in headings. The policy also notes that editing of comments can be controversial and should not be continued following a request to stop. I think it would be helpful if you reverted the edits you have made that are not consistent with these policy points.Aspheric (talk) 21:02, 15 January 2013 (UTC)

I know definitions have been argued to death but I think the current first sentence is NOT consistent with WHO / Cochrane / NCCAMS either as a theoretical or operational definition.

The definition that these bodies use is "Not part of conventional medicine". None of them go on to define 'conventional medicine' as using the 'scientific method' in this context. To do so (im my view) creates a logical fallacy.

In effect we are saying "altenative medicine is the opposite to conventional medicine, doctors use the scientific method, therefore alternative medicine is the opposite of the scientific method". The is wrong for the same reason as saying "sally is a girl, girls are short, therefore sally is short."

The scientific method is an important aspect of medicine but is a small part of what makes a good doctor/nurse. It is subject to abuse [8] and occasionally subject to ridicule [9]

By starting off this way we immediately create a battle line between "nerds and hippies" which makes it hard to edit the rest of this article collaboratively, the article turns in to a polemic and the reader suffers.Aspheric (talk) 22:30, 2 January 2013 (UTC)

Note: Aspheric's example of wrong reasoning, "sally is a girl, girls are short, therefore sally is short." is called a syllogism, which Aspheric claims is wrong reasoning. Aspheric and a handful of other editors want to remove this and similar sources from the lede - Beyerstein, B. L. (2001). "Alternative medicine and common errors of reasoning". Academic Medicine : Journal of the Association of American Medical Colleges 76 (3): 230–237 24.130.156.204 (talk) 20:45, 12 January 2013 (UTC)

Re - "The is wrong for the same reason as saying 'sally is a girl, girls are short, therefore sally is short.'". "If Sally is a girl, and girls are short, then sally is short" is a valid inference, not an invalid inference. If it is based on science, it is medicine, not alternative medicine. If it claims to heal but is not based on science, it is alternative medicine. No definitions are inconsistent. The three called "more broadly", i.e., those referring to what is "not as practiced", are the same as the definitions in the other ten sources, since what is practiced is the stuff based on science. Those definitions are just a little less complete in that they require an extra step of looking up what is practiced, which is that which is based on science. There is no inconsistency in the sources or in the definitions in the article. 64.134.228.53 (talk) 22:45, 2 January 2013 (UTC)

But what if Sally is a tall girl ? I think the omission of the term 'scientific' by WHO / NIH, etc... is deliberate and the article suffers when we try to create a false dichotomy. A scientific approach is important but even within mainstream medicine people argue whether 'conventional medicine' is really an art or a science [10]. Only a minority of therapies are based on Randomised control trials, the widespread use 'off label' medicines and the absence of studies where the answer is obvious [11] are 2 examples of where the scientific approach breaks down Aspheric (talk) 23:03, 2 January 2013 (UTC)

If Sally is a tall girl, then it's not true that "girls are short." You are talking about the difference between a sound and a valid argument. Nobody cares what the WHO, NIH, etcetera says AT ALL. They are ultimately political, not scientific. What matters is what reliable sources can verify. Greg Bard (talk) 00:03, 3 January 2013 (UTC)

Yep, I think it's an invalid argument, i.e. the inference that conventional medicine is 'scientific' and alternative medicine is 'not scientific' is a gross oversimplification. Do the definitions from WHO/NIH/Cochrane not qualify as reliable sources (it's a genuine question - I don't know what the rules are for heirachy's of evidence are on wikipedia)? reliable sources describes "a position statements from nationally or internationally reputable expert bodies" as ideal medical source Aspheric (talk) 00:13, 3 January 2013 (UTC)

NIH, WHO, NCCAM, IOM, etc. are very reliable sources according to WP:RS. The current article defines CAM as those therapies not based on evidence. This definition is flawed because it does not account for the fact that:

1. “certain CAM interventions do have evidence, and the entire industry should not be tarred with the same brush” as was pointed out in an article in the Australian Medical Journal [12]
2. Some CAM have Cochrane reviews that say they are effective: "The results from all eligible Cochrane reviews of CAM therapies were assigned to one of the following categories.....The largest number of treatments described in the reviews were classified as insufficient evidence of an effect (n = 82; 56.6 percent), followed by positive effect (n = 36; 24.8 percent) and possibly positive effect (n = 18; 12.4 percent)" [13].
3. Some CAM are accepted as effective treatments in the medical literature "Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option."’’ [14]

Moreover, if CAM are those therapies supposedly defined as being "not based on evidence", then mainstream medicine must be defined as those therapies based on evidence? How do we account for the fact that "only retrospective or anecdotal evidence (level 3 evidence) was available to support 55% of the identified decision/interventions" in hematology-oncology [15].

There is a good reason why well-recognized international medical bodies like WHO, Cochrane collaboration, NIH and IOM define CAM very differently from the definition emphasized in our current lead...the definition in our current lead is flawed.Puhlaa (talk) 01:36, 3 January 2013 (UTC)

Many thanks but what is the answer to my question i.e. - "what is the heirachy of sourcing and how do we sort the wheat from the chaff ?" It's not difficult to find journal articles that describe alternative medicine as mumbo jumbo, nor is it difficult to find high quality journal articles that decry all doctors/scientists as fraudsters[16] and characterise the widespread use of alternative medicine a "biting criticism of conventional medicine"[17].

As Nigel Molesworth would say[18], this all makes for a terrific bun fight but doesn't help little Jonny who needs to write an essay on alternative medicine and finds the normally useful wikipedia either one sided or composed of tit for tat arguments. In academia, senior editors and peer reviewers filter out the extreme views and maintain balance. What is the equivalent here ?Aspheric (talk) 02:20, 3 January 2013 (UTC)

• My apologies for not answering your specific question Aspheric! In medical category articles like this one, to determine the sources that are reliable, and the relative ranking of those sources that are considered reliable, we use policies like WP:MEDRS. To decide what gets the most weight in the article, and what does not get any weight, we usually use policies like WP:UNDUE, which is a part of the greater policy WP:NPOV. Give those a read (if you haven't already) and let me (or another editor) know if you have any questions.Puhlaa (talk) 02:43, 3 January 2013 (UTC)

In reply to Aspheric: as you said, the definition has been argued to death. The previous (very long) discussion discussed the same issues, and closed with WP:CONSENSUS for the current version. You can find it at Talk:Alternative_medicine/Archive_21, the first ~2/3 of the page (unfortunately, you'll have to check the timestamps as the discussion is unfortunately not in strict chronological order; you'll probably need to cross-reference with the page history as well to determine what versions are being discussed). There is some further background near the bottom of Archive 20. Arc de Ciel (talk) 10:11, 3 January 2013 (UTC)

There is most definitely not consensus for the current version! This discussion [19], this discussion [20], this discussion [21] and now this current discussion are all initiated by, and commented in, by various editors that feel that the current lead is problematic. Some of the major concerns are described in this[22] post by an objective editor. Some of the other major concerns have been 1) the article describes CAM as fraud, but then says NIH has a CAM branch, suggesting NIH may be involved with fraud; 2) the article primarily defines CAM with a flawed definition (as detailed above) used by a minority of sources; 3) The lead gives low-quality sources like the news brief in CMAJ that was written by a freelance-writer [23]more weight than high-quality sources like WHO, IOM, NIH, BMJ. 4) The least weight in the lead is given to a definition that is described as "commonly used" and "inclusive" in reliable sources.Puhlaa (talk) 16:53, 3 January 2013 (UTC)

Wow, I'd only looked at this page. Talk about 'tip of the iceberg'. So much effort for 4 paragraphs and it still has problems ! I'm unlikely to be able to sort out issues that have vexed better minds than mine but perhaps I can summarise some of the more obvious problems with the lead and suggest a possible way forward:

• 1. Science vs Non-science. None of major bodeis or major journals (WHO/NIH/Cochrane/BMJ/NEJM) defines alternative medicine as "not scientific" but instead of using one of these references, the central reference of the lead is based on the pseudoscience section of a non medical primary source. This seems inconsistent with editing guidence and sets up an antagonist relationship between editors.
• 2. The lead is a good description of the critiscm section but not of the article proper.
• 3. There does not appear to be a heirachy of evidence. Because this is such a broad and controversial topic, it's not difficult to find a pubmed paper to say whatever you like. In the absence of the equivalent of an "editor in chief" we need some way of ranking / weighting the different references. The lead is top heavy with critical articles, the logical next step would be to challenge or contextulise each assertion. This will lead to "Hippies are naive soap dodgers[24] but on the other hand lab geeks are lying hypocrites[25]. This would improve balance but would disserve the reader.

Solution ? I would suggest going back to an older version of the lead, remove comparisons to 'conventional medicine', bringing the 'critiscm section' up the article so it's the first section after terminology and beefing up 'criticsm' with the refs that are currently in the leadAspheric (talk) 19:09, 4 January 2013 (UTC)

I've listed the current sources in the lead and tried to distinguish which ones should and shouldn't be there. As I understand, the lead is simply a description of the article so ideally it shouldn't have any references but since it does and since it's a sticking point, lets take another look at them. Refs 8 and 17 are really at the bottom of the first category and at the top of the second.Aspheric (talk) 20:09, 5 January 2013 (UTC)

I am, for the most part, in agreement with your analysis of the sources from the lead below Aspheric. One thing that I would watch-out for, if your goal is to avoid controversy, is many editors here do not agree that NCCAM is an authoritative medical source. Although it is a branch of NIH and is mandated to producing and assess the evidence surrounding CAMs, it has been criticized here by some editors as being too 'CAM-friendly'. Puhlaa (talk) 22:23, 5 January 2013 (UTC)

Thanks very much Puhlaa, I was relying on the NIH tag but am not really fussed about using NCCAM or not. I haven't including Cochrane (or NEJM), although I think they use the same definition. Ideally the article would open with Cochrane/WHO and maybe have just one other reference in the lead. Looking back at previous edits I'm not convinced the article is "better" than the version on 29th Oct. Back then, the lead was poorly sourced but did a good job of introducing the topic. The referencing is now better (though still poor) but the lead doesn't explain the topic very well at all.Aspheric (talk) 22:46, 5 January 2013 (UTC)

The list above is so ambigous as to be unintelligable. Alterations to the article should not be made based on it. If there is a specific source that is claimed not to be reliable, then state what sentence it supports and why it is not reliable. Otherwise, such sweeping comments as below are unintelligable. The BJM, etc., sources, when cited, should always include the context in which "conventional" is used - "unconventional" refers to things not based on science, and does not refer to things that are based on science, but are uncoventional because they are outdated or too new or expensive to be common. Otherwise, a user of this article might walk away thinking that BJM, NIH, Cochrane, etc., are promoting the possibility of etiological supernatural energies existing, as claimed in Reiki, Chiropractic, Voodoo, Acupuncture, Homeopathy, etc., which is not true. — Preceding unsigned comment added by 64.134.225.194 (talk) 16:13, 6 January 2013 (UTC)

I think you've misunderstood the headings. The list is based on article strength as per [WP:MEDRS] only not on my opinion of the sources or my interpretation of their contents Aspheric (talk) 17:56, 6 January 2013 (UTC)

It looks like you are proposing massive edits without specificity. MEDRS speaks for itself, and there is no reason to restate it all on this talk page. — Preceding unsigned comment added by 64.134.225.194 (talk) 18:54, 6 January 2013 (UTC)

And without sensitivity either (geddit?). The lead is a mess, it's unrealistic to 'redefine' conventional, this is the best way forward. Let's get started ! Aspheric (talk) 19:40, 6 January 2013 (UTC)

It looks like you want to remove all sources that say alternative medicine is based on traditional use, belief in supernatural entergies, etc., instead of being based on proven medicine. Why would you want a reader to think that alternative medicine is based on things proven with scientific method, when it is not? 24.130.156.204 (talk) 02:36, 7 January 2013 (UTC)

The article has lots of problems, the lead is the main one, the issue is quality of sources. Lets stay focused. If there are no other comments on the sources in the lead, then I'll assume we are good to change the first sentence and I'll start moving the other sources in to their respective sections.Aspheric (talk) 21:02, 6 January 2013 (UTC)

The first sentence should not be changed becuase Aspheric finds that its source, the National Science Foundation, is not a "quality source". NSF is a quality source. 24.130.156.204 (talk) 22:44, 6 January 2013 (UTC)

In the right context it could be a very good source but in the way it's used it's a non-medical primary sourceAspheric (talk) 22:54, 6 January 2013 (UTC)

The second sentence is based on the following sources -

• National Science Foundation is a quality reliable source.
• National Institute of Health is a quality reliable source.
• New York Academy of Sciences is a quality reliable source.
• Nature Medicine is a quality reliable source.
• Journal of the Association of Medical Colleges is a quiality reliable source.
• American Psychological Association is a quality reliable source.
• Medical Journal of Australia is a quality source Aspheric is incorrect.
• Canadian Medical Association Journal is a quality reliable source.
• Carl Sagan on use of the scientific method is a reliable source.

Aspheric's proposal to remove these good reliable sources, as "poor quality", is not a good one. 24.130.156.204 (talk) 01:32, 7 January 2013 (UTC)

Says the guy who won't log in. In any case I completely agree; "this is a project to make the world a better place by giving away a free encyclopedia". The current article is not encyclopaedic by anyone's standards. I'm not brand new, I've been using wikipedia for a long time as a user, an ip and now an editor. WP:MEDRS was pretty much the first thing I read. Perhaps I should have stuck to the article I came here to edit, I probably wouldn't have started here if i'd known the trouble it would cause but I'm here now and want to contribute. I welcome other editors scrutanising my edits. That is the strength of this project, others looking over my contributions and improving them so that the whole becomes greater than the sum of its parts. Try assuming good faith, what's the worst that could happen ? Aspheric (talk) 23:31, 6 January 2013 (UTC)

Many thanks for looking at the list. Here is my view -

• National Science Foundation - primary source, non-medical
• National Institute of Health - authorative medical source but I don't think it's used to support the second sentence
• New York Academy of Sciences is a quality reliable source - op-ed/narrative review, non-medical
• Nature Medicine - book review
• Journal of the Association of Medical Colleges - core journal but low impact factor, op-ed/narrative review
• American Psychological Association - book review
• Medical Journal of Australia - good quality source, could be used as secondary source, currently primary source
• Canadian Medical Association Journal - news article
• Carl Sagan on use of the scientific method is a reliable source - popular science book

Aspheric (talk) 23:41, 6 January 2013 (UTC)

• NSF is not a primary source. In fact, it lists primary sources in its bibliography
• NIH is not a primary source.
• NYAS is not an "op- ed/narrative review"
• All of the sources, and many more, say the same thing, that what is licensed and practiced ("mainstream") is based on proven science, and alt med is that which is not.

I think we're making progress Aspheric (talk) 02:54, 7 January 2013 (UTC)

• NSF - Source states " As used here, alternative medicine refers to all treatments that have not been proven effective using scientific methods" I think this qualifies as a primary source
• NIH - I think it would be an excellent source to use. Are we referring to the NCCAM definition
• NYAS - it's certainly not a systematic review, it's non-medical and probably should carry the same weight as Ernst's review in JRCM
• None of the best quality sources oversimplify the issue to mainstream medicine is science, alternative medicine is not.

Aspheric, why would you spend so much time and effort to try to get a user to believe alt med is based on proven science, when it is not? 24.130.156.204 (talk) 02:28, 7 January 2013 (UTC)

I'm not. See belowAspheric (talk) 02:54, 7 January 2013 (UTC)

I attempted a bold new first paragraph but it quickly got reverted [26]. I'd be interested in what others think ?Aspheric (talk) 00:53, 7 January 2013 (UTC)

The "bold new edit" was to remove nine of the ten first sources from the lead, including National Science Foundation, New York Academy of Science, Nature Medicine, Journal of American Medical Sciences, Nature Medicine, Journal of Psychological Association, Medical Journal of Australia, Canadian Medical Association Journal, and Carl Sagan on scientific method. These are good reliable sources, inclusion of which was discussed fully, and put in with almost unanimous consensus, except for a small handful of editors. Why would you want a reader to think alternative medicine is based on proven scientific methods when it is not? 24.130.156.204 (talk) 01:32, 7 January 2013 (UTC)

Thanks for your comments, the long list categories sources in the lead in to high, good and low quality and primary / secondary. I've un-collapsed it as I think it's central to the discussion. The lead probably doesn't need 26 references particular when not all of them are the same quality. The problems with the 10 that you cite are listed above. If it's unanimous, it's not normally 'except' anything. You seem to know this site pretty well. Would it be worth logging in ? Aspheric (talk) 02:03, 7 January 2013 (UTC)

Aspheric, why would you want a reader to think alternative medicine is based on proven scientific methods when it is not? 24.130.156.204 (talk) 02:22, 7 January 2013 (UTC)

I don't want the reader to think anything. I want the article to reflect the best authorative references on the subject. I hope you do as well. None of the best sources create a division between science and anti-science. I don't know why this is an issue hereAspheric (talk) 02:33, 7 January 2013 (UTC)

Then either cite a source for an example of alternative medicine that is based on what is proven with the scientific method (based on, not based on somthing else, but tested and moved to the evidence based medicine category if proven, as might be expected of herbs in the same proportion as randomly tested ones), or cite an example of what is proven with the scietific methods that is alternative medicine, and not evidence based medicine, or stop trying to make an ambiguous and misleading distinction that is in conflict with NSF, NYAS, NIH, and all these premier cited sources. Instead of responding, you simply start a new section. The cited sources talk about doing this, including in NSF. 24.130.156.204 (talk) 02:47, 7 January 2013 (UTC)

That's not the issue here. The issue is proper use of the best authoritative material. I'm not interested in science/anti-science debate. I think we'd make progress if we examined each of the sources as per WP:MEDRS decided which were primary,secondary and tertiary sources and which were high,medium and low quality.Aspheric (talk) 02:58, 7 January 2013 (UTC)

Note: the following is discussing Aspheric's recent edit to the lede, with edit summary "New lead for discussion" [27] 24.130.156.204 (talk) 20:19, 12 January 2013 (UTC)

I think we've come full circle, the definition and terminology sections are key since it's impossible to have a sensible discussion if we can't agree what we're talking about. It's a fine to have some examples but the Wikipedia pages for each therapy are likely to have better detail.

If we do decide to include examples, then there should be some structure, ideally from a strong review e.g. from the Nature immunology or at least classifications from the US or Danish groups that sort therapies by level of evidence or body systems.

There have only been a few comments on the proposed changes to the lead. One criticism but that appeared to be based on a misreading of the main sources on the topic. As ever, thoughts and ideas, comments and critism welcomed.Aspheric (talk) 17:29, 12 January 2013 (UTC)

Looks acceptable to me, subject to anything cogent and reasoned from other editors wishing to let the article be improved for the general reader (including any who are journalists, writers, publicists). Qexigator (talk) 17:45, 12 January 2013 (UTC)

It's not clear which thread is discussing the new lead. It's an extraordinary improvement. Thanks so much to all who've contributed to these discussions. TimidGuy (talk) 18:07, 12 January 2013 (UTC)

Yes, good work! Gandydancer (talk) 18:38, 12 January 2013 (UTC)

Excellent work the new lead is a definite improvement! Puhlaa (talk) 19:31, 12 January 2013 (UTC)

• This appears to be the same discussion of the lede as above, but using "alternative wording" to appear to be a discussion of a new topic, opened under a header "defiitions", after Aspheric was asked to stop discussing the definitions in the lead in unrelated talk page sections, when there was already many sections on the lede and its definitions. 19:41, 12 January 2013 (UTC) — Preceding unsigned comment added by 24.130.156.204 (talk)

This comment applies here: P24-'s recurrent reverts are less helpful than s/he would have it believed. Failing to identify which of the sources s/he is complaining about is no way to let the article be improved. The point is not made by irrational remarks about a small number of editors. Who finds that in any way convincing or even persuasive? And confidence is not being raised by failure to log in. Is this an exercise of some admin privilege? Please disclose. Qexigator (talk) 20:16, 12 January 2013 (UTC)

--And now changing section titles here in a way that is more disruptive than helpful. Qexigator (talk) 20:45, 12 January 2013 (UTC)

WP:RTP discusses your one point. Aspheric claims to be a "new" editor on his user page, and used this "newness" to explain edits in talk pages. The handful objecting to NSF as a source and who were out of the general consensus on sources includes Qexigator, Puhlaa, Gandydancer, TimidGuy, and a couple of others. The following is a list of Aspheric's clearly warring edits, ignoring previous general consensus on keeping NSF, NYAS, Academic Medicine, etc., as a reliable source, but since he is "new", he is not aware of 3RR -

• http://en.wikipedia.org/w/index.php?title=Alternative_medicine&diff=532358556&oldid=532268119
• http://en.wikipedia.org/w/index.php?title=Alternative_medicine&diff=530989645&oldid=530376342
• http://en.wikipedia.org/w/index.php?title=Alternative_medicine&diff=531705263&oldid=531693371
• http://en.wikipedia.org/w/index.php?title=Alternative_medicine&diff=532237126&oldid=531848398
• http://en.wikipedia.org/w/index.php?title=Alternative_medicine&diff=532724722&oldid=532449632 24.130.156.204 (talk) 22:13, 12 January 2013 (UTC)

Oh dear. I'm sorry you think i've been edit warring. You'll notice that the edits above evolve with the discussion we've been having on the talk page. I think this is more consistent with bold, revert, discuss than 3RR, particularly since at a push it's been 3 edits in a week. I don't think there ever was 'consensus' over the lead and if even if there was, this may have changed. I think changes to the lead should be considered and commented on, sadly the suggestions i've made have been quickly reverted with very little directional feedback. There are important points on all sides that need to be made regarding definition and terminology and it's disappointing that these issues haven't been clear in the discussion.

I don't think the changes on the talk page have helped clarify the topics or have been performed with the care that WP:RTP requires. I also think the new section on examples has major problems in it's current state. The points that 'Q' makes above seem reasonableAspheric (talk) 23:07, 12 January 2013 (UTC)

You wrote that you were a new editor when you were not, then you removed the National Science Foundation source from the lead five times. That's edit warring (and possibly worse). 24.130.156.204 (talk) 00:05, 13 January 2013 (UTC)

I wrote on my user page that "i'm new but already have my sights set on the 'most pretentious user name award' on wikipedia". This could be interpreted that as an attempt at humor, humility or self depreciation but it's a stretch to say it's a deliberate attempt to mislead. I'll remove the frist 3 words if it's causing distraction. I think NSF may have a place in the article but is poorly suited for the lead. Interested in other peoples views. Aspheric (talk) 12:51, 13 January 2013 (UTC)

Please note that Qexigator is not one of a "handful objecting to NSF as a source and who were out of the general consensus on sources" as asserted by IP 24--. In fact that looks like a deliberate smear on other editors, for reasons unknown to Qexigator. The National Science Foundation, an agency of the government of the USA, and the New York Academy of Sciences founded in 1817 and now "one of the most significant organizations in the international scientific community", are obviously notable, both are written up in Wikipedia, and are influential and widely esteemed. Is it proposed that this alone is enough to make anything either of them sponsors or publishes a good source for the present purpose, eg in the case of a piece which is "not a systematic review, it's non-medical and probably should carry the same weight as Ernst's review in JRCM" (NYAS), or in the case of a "primary source, non-medical" (NSC)? Is there any reason to object to either body in principle as one of the sources for this article? Is it essential for them to be referenced from the lead and not the body? Need this be so contentious? Is IP 24-- protesting too much? Is s/he over-anxious about defending a position or attacking another? Qexigator (talk) 00:18, 13 January 2013 (UTC)

Quexigator, why did you just write of Aspheric's fifth revert deleting the NSF source - "Looks acceptable to me"? 24.130.156.204 (talk) 01:16, 13 January 2013 (UTC)

• Logged in editors who are interested in letting the article be improved are invited to see my comments 1_ IP24-'s recurrent reverts are less helpful... 20:16, 12 January 2013 (UTC) and 2_Please note that Qexigator is not one of a "handful objecting to NSF as a source and who were out of the general consensus on sources" as asserted by IP 24--.... Is IP 24-- protesting too much?... 00:18, 13 January 2013 (UTC) Qexigator (talk) 18:05, 13 January 2013 (UTC)

I'm not sure how we moved from looking at the lead to looking at users but ... I have made edits prior to 30th Dec. Not sure how many but i think my total edits will just about put in the Novice editor stage[[28]]. Is that new ? Does that help ? It's seems odd to have these questions from '24' whose edits suggest that they are more knowledgeable/experienced than many users here but despite this, they choose not to log in.

I haven't deleted any sources, I've tried to improve the lead and have moved critical sources to the 'criticism' section. I don't mind justifying my edits but I don't think we should get distracted from defining and structuring the topic in a neutral and logical manner. I hope that doing so will reduce arguments and allow the rest of the article to take form in a straight forward manner. I think it would be a stretch to view my few edits as 'warring'.

There are some excellent accessible reviews that provide a good overview of this topic. Wikipedia should be one of them. The changes to the talk page and deletion of certain comments have made it very difficult to follow what's been going on.Aspheric (talk) 02:21, 13 January 2013 (UTC)

Aspheric, what was your previous username? Did you previously do any edits on any alt med related articles? Did you previously do anything related to the lede edits you are now trying to make? 206.59.51.2 (talk) 14:06, 13 January 2013 (UTC)

The answer to your questions is no, no and no respectively. Please stay on topic. Thanks. Is '206' the same user as '24', is that the same as '64'. Would appreciate some clarification Aspheric (talk) 16:58, 13 January 2013 (UTC)

Aspheri's edit removes that some alternative medicines are based (only) in tradition or beliefs in supernatural forces. It also removes that some are based on fraud or pseudoscience. SBHarris commented in Talk:Alternative_medicine#conventional_.3D_state_board_.22usual_standard_of_care.22.3F that using the NCCAM source was a bad idea, but the text in the first sentence "not integrated into the dominant health care system" comes from the NCCAM source, even if it's not explicitly cited. The WHO page is a subpage and partly based on the NCCAM source. There are pages higher in the hierarchy that try to define traditional medicine and don't include that part: "Traditional medicine that has been adopted by other populations (outside its indigenous culture) is often termed alternative or complementary medicine." fact sheet, "In some countries, it is referred to as "alternative" or "complementary" medicine (CAM)." [29]. In short, I am not very convinced that this new lead is good. --Enric Naval (talk) 18:55, 13 January 2013 (UTC)

If so, surely it is not too difficult for it to be emended by those better conversant with the topic, to the evidently small (albeit significant) extent that is needed, so as to provide what is suited for informing a reader? Why the drama? Qexigator (talk) 19:54, 13 January 2013 (UTC)

Pretty much every decent medical source refers to the NCCAM definition as its starting point. This includes those that criticise it (e.g MJA). The changes I proposed are not supportive of alternative medicine, include major criticisms and provide an overview of the topic that is consistent with the best medical papers as per WP:MEDRS. With the best will in the world I can't see any justification for starting with any other definition. Aspheric (talk) 21:19, 14 January 2013 (UTC).

• Ref 1 - NSF definition. flawed source, see above
• Ref 2 - Book Healing Traditions. Page 2 does not say alternative medicine is based on superstition, instead it criticizes others for 'incorrectly' stating alt med it is based on superstition
• Ref 3-6: flawed sources, see above
• Ref 7 - describes the establishment of an alt med research institute. To use this to infer that alt med is unproven is like saying the establishment of a cardiac research lab proves that cardiology is unproven
• Ref 8 - Nature immunology does not state that alt med is unproven / disproven. page 914, col 2, para 2 states There are numerous publications describing the therapeutic efficacy of CAM modalities that are thought to mediate their effects through the immune system, all reporting varying degrees of evidence"
• Ref 9-13 - None of these articles uses the term science based. See above

I'll correct some of the more outrageous use/misuses of sources but will let others discuss the pros and cons of which sources to use. Aspheric (talk) 12:18, 16 January 2013 (UTC)

Mao invented Traditional Chinese medicine as a Communist promotion, and created mythical folk heroes as historical medical figures.^{[citation needed]} Efficacy of Acupuncture was a fraud perpetrated by the Chinese Communists in the early cultural exchanges between the United States and China.^{[citation needed]}

Does anyone know any reliable sources for this, so it can go back in the criticism section, where the basic content once occured (with different wording), many versions ago? 64.134.225.194 (talk) 15:29, 14 January 2013 (UTC)

All mention of this seems to have also been scrubbed out of the TCM article. Here, Mao's Barefoot Doctors: The Secret History of Chinese Medicine - Westerners' belief that Chinese have long relied on alternative medicine is due in part to being duped by book publishers, is some info on it, from one of the thousands of web sites about the scam, which seems to still be alive and well, even at Wikipedia, where all mention of this mega-fraud seems to have been slowly scrubbed out of relevant articles. 64.134.225.194 (talk) 15:49, 14 January 2013 (UTC)

That is an interesting piece of information (May 24, 2011)[30], and gives a valuable perspective to the whole of this article, much better than shouts of "propaganda" or "fraud". Unless it has been refuted and not merely suppressed, let its conclusion be mentioned somewhere in the article: ...when we look at the history as a whole, we find that alternative medicine did not represent what knowledgeable Chinese doctors would have prescribed, at least not since the dawn of science-based medicine; and so the argument that alternative medicine is valid because the Chinese use it, is false. And we also find that the skeptical claim that Mao promoted alternative medicine through the barefoot doctor plan because it was cheap is not quite true either. The plan was an honest attempt to provide the best available medical care, and it only fell back upon alternative therapies when nothing else was at hand... It's lead is Westerners' belief that Chinese have long relied on alternative medicine is due in part to being duped by book publishers. Qexigator (talk) 17:23, 14 January 2013 (UTC)

As I recall, TCM was overtly intended as a mass fraud by Mao, making up barefoot doctor heroes, etc., and they pulled a fast one on the American media with the acupuncture nonsense when Nixon in China was big. They openly admitted it was false, but the way propoganda works, it didn't matter. The new age times in America ignored facts, (recall, they were trying to levitate the pentagon using love, around this time), and money was to be made, and was made. Chiropractic adopted marketing, not statistical analysis of biodata, as its requirement, and similarly took off. You should purchase that NYAS article if you like reading this kind of stuff. It is a very good article, a centerpiece of the academic views on alt med, with lots of even more bizarre historical facts. (And the horror stories of propoganda and worse in "science" based medicine are equally astonishing, but at least some of it really is based on science.) There is a good new book by a Harvard historian and philosopher of science, Carla Napi , a disciple of Ian Hacking, on TCM history. Real TCM uses incredibly toxic poisons as its most valued "medicines" (e.g., aconite), and has stuff like "rope of a hanged criminal", which is believed to contain the "substance" of the criminal's human soul in it. Mao's version, all phony, all an invention, is less bizarre than the real thing. 24.130.156.204 (talk) 02:37, 15 January 2013 (UTC)

The real thing - “Drugs like corpse worms, rotting bones, and the petrified charcoal-like essences of suicides who hanged themselves” (p189).

“Urine (especially that of young boys)… As a surefire cure for sudden cramps in the abdomen… a patient have someone sit on him and urinate into his navel.

And it gets more extreme, with human feces pickled in licorice, aconite (King of the TCM herbs - the single most highly valued of substances in real TCM is the legendary "queen of poisons" of Europe)[31], arsenic, lead, ...

Chinese "knowledge" is particularly resilient to change, so this stuff stuck around for a very long time. It was not until Mao came along that much new came in. Like they say, 5,000 years of knowledge! Must be something to it. Get your navels ready, here come the boy scouts. 24.130.156.204 (talk) 03:01, 15 January 2013 (UTC)

It has to be modern TCM - the other stuff doesn't qualify as an alternative medicine. One can allude to the fact that TCM was modernised in a process dating from the late 19th century, that there were various attempts to unify Western and Chinese medicine; and that, despite decades of opposition from the National Government and continuing into the early years of the Communist regime, it was embraced during the Cultural Revolution partly as an expediency. The critical problem, however, is tracing properly its transmission to the West as contact with Chinese medicine precedes the 1970s. FiachraByrne (talk) 21:15, 15 January 2013 (UTC)

Is it dangerous to put real TCM info in Wikipedia? People believe in alt med. What happens if they believe in TCM and read this? This is intended to be a serious topic of discussion, so please comment with the fact in mind that people might really believe TCM, and might get ideas if real info on it is in WP. It would be like putting methods of suicide in an article on methods of suicide. 24.130.156.204 (talk) 03:26, 15 January 2013 (UTC)

No, I don't think it's appropriate to put information from what you term "real" TCM into this article. Best to focus on the modern TCM which actually constitutes an alternative medicine in a "Western" context. It is appropriate for inclusion in the history section of the Traditional Chinese Medicine article, of course. Looks interesting too. FiachraByrne (talk) 21:08, 15 January 2013 (UTC)

If the population of the USA has been that gullible and susceptible to mass deception by publishers, should it not be mentioned explicitly in the article? TCM was overtly intended as a mass fraud by Mao... and they pulled a fast one on the American media... when Nixon in China was big. Qexigator (talk) 09:00, 15 January 2013 (UTC)

Welcome to having your eyes opened. I was one of those duped, and I was even a person on TV in the 70's promoting the wonders of alt med, and the pitfalls of mere physics, which was proven to have totally missed the mark on energy, since qi was so real that everyone "saw" it work in the acupunture on TV. I would say LOL on me, but it is not funny. 64.134.222.106 (talk) 14:18, 15 January 2013 (UTC)

Well, I am keeping an open mind pending sight of corroborative information. If the mass deception is an acknowledged fact in USA and can be sourced perhaps it needs it own article? If not yet covered by Traditional Chinese medicine, would that be the place for it? Qexigator (talk) 14:51, 15 January 2013 (UTC)

Wikipedia cannot be used with a purpose of "warning", but it does improve Wikipedia to add information that has reliable and verifiable sources, and to look into why it was previously deleted. 64.134.225.194 (talk) 15:45, 16 January 2013 (UTC)

This section largely follows categorization of NCAAM, NIH, and NSF, together with some other reliable sources. It is largely sourced by NCAAM, NIH, and NSF. The examples are mostly chosen by NCAAM, NIH, and NSF, but they are also supported, as to Weight, by the sources on prevalence of use in the article body sections below this section. Comments? 64.134.225.194 (talk) 16:45, 14 January 2013 (UTC)

Could you provide links to the NCCAM, NIH and NSF pages please. It is difficult to recognise the source from the tone and content of the current articleAspheric (talk) 18:46, 14 January 2013 (UTC)

Sources are in the reference section corresponding to their footnote number. 64.134.225.194 (talk) 15:41, 16 January 2013 (UTC)

Don't forget, MOS - use plain English, whenever possible. 64.134.225.194 (talk) 19:54, 14 January 2013 (UTC)

If the convention is to use "supernatural" instead of "antiscience" in the belief that this is in the service of "plain English" for the purposes of this article, then it would help all parties (plain readers and plain editors) if this were stated in the lead or in a note to the lead. Most editors will be aware that there are few literary, scientific or academic contexts where these would normally be treated as synonyms. Properly used, they in fact denote significantly and materially different concepts. Undeclared conflation spreads confusion more than clarity of communication. Qexigator (talk) 22:20, 14 January 2013 (UTC)

You are wrong that qi energy and chiropractic vital energy are energies of physics. They are not. They are supernatural energies. The sources say both "supernatural" and "antiscience". 24.130.156.204 (talk) 02:25, 15 January 2013 (UTC)

The unsigned imputation of error (expressed ad hominem) is evidently based on a misreading of the logged in comment above, apparently due to false inference. Qexigator (talk) 08:39, 15 January 2013 (UTC)

Please may we have comments on this talk page expressed in common simple English. Talk pages are interned to help develop an article and comments should be easy to understand for everybody, including those whose first language is not English. To start with, can somebody explain (for instance) what The unsigned imputation of error (expressed ad hominem) is intended to mean ? Thank you.  Velella  ^{Velella Talk}   09:51, 15 January 2013 (UTC)

Dear V.: I guess you know very well, and so would others. Let's not underestimate the literacy of IP64- or others in the discussion here. It would be too brusque, if more readily understood by editors whose English is actually or virtually the mother tongue, just to say "skip it" (as in 2a of [32], or [33]. Qexigator (talk) 13:01, 15 January 2013 (UTC)

Had I understood, I would not have asked.  Velella  ^{Velella Talk}   13:26, 15 January 2013 (UTC)

That surprises me, V., and even more that you felt an urge to comment in that way, but all the same: Cheers! Qexigator (talk) 13:56, 15 January 2013 (UTC)

Re "unsigned imputation of error (expressed ad hominem) ... apparently due to false inference" - ???? - And in a section titled "use plain English", too. And the talk page section above titled "ex hypothesi", if you google the expression, you will find that it was not just made up, but is sopmething called "new latin", apparently coined in 1603. But what that talk page section is about, and how it relates to the title, is beyond my plain English brain.

Is anything written in this section on topic to the section title and opening comment? If not, someone who understands what the offtopic words mean, should collapse the offtopic parts. 64.134.222.106 (talk) 14:27, 15 January 2013 (UTC)

I do however understand attempts at being patronising. I do also understand when overly complex English is used intentionally or unintentionally to deter others and restrict debate. My comments do not relate to IP64 or probably any of the current contributors, but rather to the potentially very many editors who could contribute very usefully here but who have neither the time nor the inclination to penetrate the dense obfuscation that characterises several key sections of this discussion page - thankfully less so in the article itself.  Velella  ^{Velella Talk}   21:34, 15 January 2013 (UTC)

I think it's a valid point. I think we can all fall back on jargon through habit or lazyness and it's a skill to write short, clear sentences. I also think Qexigator makes a good point. Qi is described by a good quality accessible academic source as meaning "spirit". This will mean different things to different people. But to ignore this and use words like 'supernatural' or 'antiscience' in the name of 'plain english' is in my view simply wrong. I think it allows an editor (intentionally or not) to change the meaning of a sentence without needing a source to back them up. Aspheric (talk) 22:10, 15 January 2013 (UTC)

Velella wrote, "Please may we have comments on this talk page expressed in common simple English. Talk pages are intended to help". I am repeating it here with boldface to express my agreement with Velella's request. (E.g., what does "ex hyphothesisii", or whatever, mean? Don't answer that! It was a rhetorical question.) 64.134.225.194 (talk) 15:16, 16 January 2013 (UTC)

Editors intent on improving the article are likely to regard that remark as slovenly for more reasons than one, and not inspiring confidence in edits from the same persistent unlogger. But assuming GF perhaps it may be that tetchiness is due to the late hour where IP 64- is located, and not intentionally disruptive.. Admittedly, it could be difficult to give the benefit of any doubt when faced with an edit such as Revision 14:48, 16 January 2013 (remove unsourced unverifiable sentence)[34] Qexigator (talk) 16:20, 16 January 2013 (UTC)

What does "techniness" and "slovenely" mean?

From the online dictionary - "sloven" - one habitually negligent of neatness or cleanliness especially in personal appearance.

???? 64.134.225.194 (talk) 16:37, 16 January 2013 (UTC)

This article has a history of a small number of edits that mislead readers into thinking alternative meidicine might be based on science, or that it is not based on supernatural beliefs. Common edits that do this remove the word supernatural and replace it with other words. We replaced the word "antiscience" from the source, with "supernatural", per MOS Use Plain English, and other sources cited already used the word "supernatural". I undid this edit as not being what the source says, and for this additional reason. 64.134.225.194 (talk) 21:08, 14 January 2013 (UTC)

Can you indicate which source uses the word 'supernatural' and in what context. The current text is difficult to read and does not appear to be consistent with the sources it citesAspheric (talk) 21:32, 14 January 2013 (UTC)

You are incorrect that qi is an energy recognized by physics and not a supernatural energy.Follow the link antiscience. Did you read the sources (e.g., in the lead, before trying to remove them from the lead? 64.134.225.194 (talk) 21:54, 14 January 2013 (UTC)

I think you have misread my edit [[35]]. The text proposed was Traditional Chinese Medicine is based on a concept of "spirit" called qi,. The current source is a self help book. The proposed reference is a freely available academic text which was found in the article on 'Qi'. The description of Qi is taken from page 3 of the book, where fundamental concepts of Li, Qi and Shu are discussed. Yes I have read the vast majority of sources in the lead, this is recommended in WP:MEDRS. No, I haven't deleted any. Again, what is the source for supernatural energy. ThanksAspheric (talk) 19:03, 15 January 2013 (UTC)

I have used the excellent WP article on supernatural to define the word in the lede: For the purposes of this article, "supernatural" is used in the standard sense of something that is not subject to the laws of nature as they are presently understood by natural science as a result of application of the scientific method. I think most alterative practitioners, psychics, shamans, and voodoo priests would all agree to that. But many of these people would deny being explicitly antiscience, any more than your Catholic priest down the street would describe himself as being antiscience.

The term "antiscience" itself is a difficult one. Dictionaries have various definitions of the term (also "anti-science"), and the WP article on antiscience is particularly under-referenced, confused, and not very helpful. There are as many definitions of antiscience as there are authors. But most seen to agree that antiscience is not the same as superstition or religion or (more to the point here) belief in the supernatural. These words all have different connotations and histories of use in English and are not synonyms. Nor is paranormal an exact synonym for supernatural, either (which is why there are two articles on them in Wikipedia). English is a complex and delicate language and I wish more attention was paid to it by our editors. We have enough problems here, as it is. SBHarris 01:39, 16 January 2013 (UTC)

Yes, well reasoned explanation for the edit and its place in the article and in the general Wikipedia context. Improves the lead and the aricle as a whole. Qexigator (talk) 09:30, 16 January 2013 (UTC)

No mainstream medical source uses the word 'supernatural' so I don't understand why it's in the article, let alone the lead. I don't think it's 'plain english', I think it's a word that can have negative connotations and mean different things to different people. Aspheric (talk) 11:38, 16 January 2013 (UTC)

The following lists occurrences of "supernatural" after the first 2 in the present lead. They tally with the second, but would the article be improved if "supernatural" were taken out in all cases unless sourced? _regional supernatural belief systems / _supernatural energy flow / supernatural energies/ _supernatural energies (antiscience) / _supernatural energy called qi / _supernatural vital energy / _Supernatural energies and misunderstanding of energy in physics / supernatural energies undetected / supernatural energy called qi / flow of a supernatural vital energy / centers of supernatural energies / existence of supernatural energies / purported supernatural energies of alternative medicine / supernatural beliefs can be consistently integrated / belief in the supernatural. Qexigator (talk) 12:23, 16 January 2013 (UTC)

There is no question that the energies in TCM and chiropractic are supernatural energies, and are not those recognized by physicists. "Tallying" usage to make inferences interpreting usage violates WP:OR. 153.18.112.4 (talk) 20:30, 16 January 2013 (UTC)

Revision 20:30, 16 January 2013 153.18.112.4 (There is no question that the energies in TCM and chiropractic are supernatural energies, and are not those recognized by physicists.).[36] And your point is? Why imply that anything else is being proposed in any edit I have made? Please withdraw the unwarranted comment and desist disuptive reverts, such as Revision 20:11, 16 January 2013 by 153.18.112.4 (Undid revision 533413947 by Qexigator... remove OR interpretation of use of word in sources). [37] Anyone can see that to call that OR is absurd. Qexigator (talk) 22:43, 16 January 2013 (UTC)

It is false that the "basis of treatment" in "western" medicine has anything to to with balance of the humors. That the source claims this indicates the source is not reliable, and cannot be used in this article for other things. This was undone - [the belief that health is controlled by 3 "humours" with disease caused by an imbalance of these "humours". The basis of treatment has some similarities with "Western medicine". 64.134.225.194 (talk) 21:37, 14 January 2013 (UTC)

Probably a misreading of the source which, judging from the version in the article, is likely pointing to similarities between Ayurvedic and traditional Galenic, Western medicine which followed humoural theory. FiachraByrne (talk) 02:31, 15 January 2013 (UTC)

Just to emphasise, what is termed the Western medical tradition does not commence in the late nineteenth century.FiachraByrne (talk) 02:32, 15 January 2013 (UTC)

Based on a superficial assessment of Dominik Wujastyk's profile on academica.edu, he appears to be a serious scholar of antique and medieval Asian medical history. Judging from the blurb of the book which provided the source for the sentence about humours in the Ayurvedic and Western medical traditions, it appears highly unlikely that he's talking about modern Western medicine (biomedicine).

Ayurveda, the ancient art of healing, has been practiced in India for more than two thousand years and survives today as a living medical tradition whose principles are at the heart of many "alternative" therapies now used in the West. This "science of longevity" has parallels with Buddhist thought, and advocates a life of moderation through which the three humors of the body will be brought into balance. The writings selected for this volume are taken from Sanskrit medical texts written by the first Ayurvedic physicians, who lived between the fifth century b.c. and the fourteenth century a.d. Here readers will find wide-ranging and fascinating advice on the benefits of garlic therapy, prayers for protection against malevolent disease deities, surgical techniques, exercise regimens, the treatment of poisons, the interpretation of dreams, and more.

FiachraByrne (talk) 02:53, 15 January 2013 (UTC)

Classical Indian religious painting is every bit as fascinating as that from Europe. Do you know where there might be some images of "malevolent disease deities". (Its not here - Gods of sickness and Healing) I expect any such image will likely be a real socks-knocker-offer. (Also, know of anybody ever compared Freudian dream interpretation with Auyurvedic dream interpretation? It would not be surprising if some of the later coming Freudian ideas might not be entirely original.) 24.130.156.204 (talk) 03:38, 15 January 2013 (UTC)

No and No. This is interesting but not really relevant to your questions. Is this Park by the way? FiachraByrne (talk) 10:27, 15 January 2013 (UTC)

Nice link. It is technically offtopic, since there are no reliable sources (so far proposed) calling Freudian stuff "alternative medicine", i.e., calling a spade a spade, but maybe that will change. (being alternative medicine does not mean that it is not intresting, and does not always mean that it is not convincing, just that it claims to heal and is not based on the scientific method.) 64.134.225.194 (talk) 15:36, 16 January 2013 (UTC)

The edit was based on a book review by Patterson ( Med Hist. 2001 January; 45(1): 142–143. ) of the source cited (The roots of āyurveda: selections from Sanskrit medical writings, translated by D. Wujastyk ). The Pubmed link to the full article is in the edit summary [38]. The section used was taken from page 2, paragraph 1 of the review. Ayurveda is a "humoral" system; the health of the body is controlled by three humours (dosas). Wujastyk takes issue with the commonly held interpretation that "disease is caused by an imbalance of the humours". He accepts that the idea of balance is certainly present, but he shows that disease may be more a question of misplacement than imbalance. Treatment is "allopathic"-the disease is to be countered by its opposite, as in western medicine. Remedies are largely plant, with some animal, materials. Ayurveda thus seemed immediately familiar to the first European traders, who brought with them the Galenic medicine that was practised in Europe up to the mid-seventeenth century.

The edit proposed was Ayurvedic medicine is a traditional medicine of India and has strong links with Buddhism and Hinduism. It views health as a 'humoral systems', where imbalances can cause disease but includes concepts of treatment'by opposite' that are similar to Western "allopathic" medicine. Rememdies are mainly plant based with some use of animal materials.

This was amended to Ayurvedic medicine is a traditional medicine of India and has strong links with Buddhism and Hinduism. It is based on the belief that health is controlled by 3 "humours" with disease caused by an imbalance of these "humours". The basis of treatment has some similarities with "Western medicine". Rememdies are mainly plant based with some use of animal materials. following a complaint from ip 64 that the words humour, allopathic and opposite were confusing. The ammended text was again reverted a few minutes later by the same ip.

I'm not debating whether Wujastyk's translation is a good source or not but the current sentence is a misreading of the source. I would suggest either changing the sentence or changing the source.

If the decision is to 'keep', then the following proposal removes the term "Western". Ayurvedic medicine is a traditional medicine of India and has strong links with Buddhism and Hinduism. It is based on the belief that health is controlled by 3 "humours" with disease caused by an imbalance of these "humours". Rememdies are mainly plant based with some use of animal materials. Aspheric (talk) 19:33, 15 January 2013 (UTC)

The correct source should be cited as well (book review). I think its designation as an allopathic system is interesting as is the suggestion that there was an underlying commonality with "Western" medical concepts at that time. I'm not convinced that the book review is a sufficient source to substantiate those points, however. I think in using this source it would also be important to keep in mind that it's a relevant characterisation of Ayurvedic medicine only for the period up to the fourteenth century – to assume, without a supporting secondary source, that because it is termed "traditional" it has not undergone change since the middle ages is to assume too much. Ideally, a better source than a short book review is really called for here to support the wording you offer above.

Incidentally, Medical History ran a special issue on alternative medicine in 1999. It might be of some use in broadening the focus of the article beyond the US. FiachraByrne (talk) 21:01, 15 January 2013 (UTC)

That's fine but i find it hard to believe that Ayurvedic medicine is a traditional medicine of India, and includes a belief that use of traditional herbs and having the spiritual balance of the religions of Hinduism and Buddhism, including by suppressing natural urges of food intake, sleep, and sexual intercourse, can be used to heal is a better summary of the book, the book review or the topic Aspheric (talk) 21:08, 15 January 2013 (UTC)

Fair point and that section is totally inadequate as it stands. Better, accessible sources are needed. FiachraByrne (talk) 21:20, 15 January 2013 (UTC)

The summary and examples for ayurvedic medicine was taken straight from the wiki article on it, and a source or two from the same article. It is in the most Plain English as possible, so as not to bring in words like "humors" that are far too detailed and technical for a general alt med article. If not enough of the sources were moved with the content, then the solution is to move in more sources from that article, not to alter the general summary already long standing in that article by consensus. 64.134.225.194 (talk) 16:05, 16 January 2013 (UTC)

I thinks that's true of the whole article. Even when accepted, authoritative, accessible, secondary sources are highlighted, they seem to be ignored or sidelined, in favour of unsubstantiated or contentious edits, or inaction. Very frustrating. Good link by the way, 'hermaphrodies and the medical invention of sex' is one of many intriquing looking articlesAspheric (talk) 21:23, 15 January 2013 (UTC)

Actually, I have a scanned copy of Wujastyk's chapter on Indian medicine from the Companion Encyclopedia of the History of Medicine. It might serve as a decent source to expand that section of the article. If anyone wants a copy I can email it to you. FiachraByrne (talk) 21:59, 15 January 2013 (UTC)

It might be better to add specifics to the auyervedic medicine article, not this one, since this is a general article on alt med. Specific info on a particular alt med should be kept to a bare bones minimum, unless it illucidates methods of general alt med, such as that the example of Maoist propoganda in TCM serves as an example of general propoganda used in alt med, like the use of the word "alternative" itself, which the various sources indicate was purposely chosen as a propoganda tool to create the impression that there is a healing "alternative" to just stuff based on science. The NYAS article in its entirety is well worth reading, as are the other articles from that NYAS conference on "the flight from reason". 64.134.225.194 (talk) 16:11, 16 January 2013 (UTC)

Agree with your previous comment. Attempts to either extol or denigrate alternative medicine should be jettisoned. The sole object should be to elucidate the topic using decent, representative and authoritative sources. Re Medical History: yes - it's not a bad journal and all the articles are free due to Wellcome Trust funding. FiachraByrne (talk) 22:14, 15 January 2013 (UTC)

I'll remove the second sentence till we have something better Aspheric (talk) 11:40, 16 January 2013 (UTC)

I have something better. I'm not willing to edit the page myself at the moment, although I may at a later date. Would you, or anyone else, like a copy of Wujastyk's chapter from Companion Encyclopedia of the History of Medicine?

That would be very kind[39]. Alternatively the Nature Immunology Article cited as 'Reference 8' provides the following defintion in it's glossary section: AYURVEDA The traditional Indian system of medicine. Ayurvedic (meaning ‘science of life’) medicine is a comprehensive system that places equal emphasis on the body, mind and spirit, and it strives to restore the innate harmony of the individual. Perhaps this would be suitable ? Aspheric (talk) 12:35, 16 January 2013 (UTC)

Ayurvedic medicine in terse Plain English

From the main article on the topic -

"Ayurveda or ayurvedic medicine is a system of traditional medicine native to Indian subcontinent and a form of alternative medicine. ... Ayurveda stresses the use of plant-based medicines and treatments ...Hinduism and Buddhism have been an influence on the development of many of ayurveda's central ideas – particularly its fascination with balance... Balance is emphasized; suppressing natural urges is seen to be unhealthy, and doing so claimed to lead to illness.^[1] However, people are cautioned to stay within the limits of reasonable balance and measure.^[1] For example, emphasis is placed on moderation of food intake,^[2] sleep, sexual intercourse.^[1]"

Two sources are cited.

Our mention of it says -

"Ayurvedic medicine is a traditional medicine of India, and includes a belief that use of traditional herbs and having the spiritual balance of the religions of Hinduism and Buddhism, including by suppressing natural urges of food intake, sleep, and sexual intercourse, can be used to heal.^[3]"

But only one source was carried over from the main article. 64.134.231.145 (talk) 18:14, 16 January 2013 (UTC)

The term 'Natural' is the problem. I full content from the wiki article is better. I have pasted in accross and moved the critiscm to the criticism 'safety section'Aspheric (talk) 19:03, 16 January 2013 (UTC)

I think the same is true of TCM, I've moved the content from the wiki article across. Again this should avoid disputes over the meaning of the term 'qi' Aspheric (talk) 19:19, 16 January 2013 (UTC)

Re this edit, I removed this sentence as unsourced and unverifiable. 64.134.225.194 (talk) 14:39, 16 January 2013 (UTC)

Editorializing recently added by Asphixor was removed, e.g. adding "value laden terms" to described the terms in the sources. 64.134.225.194 (talk) 14:55, 16 January 2013 (UTC)

Misinterpretation of source, edit was a direct quote, please specify reason for reverting other changes as well. Thank you.Aspheric (talk) 15:11, 16 January 2013 (UTC)

Per Weight, this is an article on alterntive medicine, not a on words like "pseudoscience" being "value laden". If you want to call pseudoscience "value laden", based on some source, try making the edit at pseudoscience, and others will help you reach consensus on its WEIGHT. 64.134.225.194 (talk) 15:59, 16 January 2013 (UTC)

I disagree but am happy to remove source and sentence. Other changes have been restored. The original version falsely implied that the source was saying that alternative medicine was supestition.

The actual text from the source is as follows Too often, these studies have been plagued with prejudgments and 'value-laden terminology', which have in some cases entirely precluded accurate presentation of information about the systems being studied. Pejorative names such as "superstition" (false belief about causal relations, generally involving supernatural or magical implications), "popular errors" (misconceptions among the laity). "old wives' tales" (silly no-tions, a term that simultaneously derides the tales and their tellers) and "quackery" (properly defined as medical charlatanism involving delib-erate deception) have sometimes been used as polemical devices intentionally to denigrate the beliefs and practices to which they refer. In other cases, they have actually been intended simply to describe, but have carried belittlement into the discussion just as surely. In any genuinely dispassionate inquiry into the nature of nonconventional healing systems, terms must be chosen with precision and care. Conclusions must follow, not precede, collection of data. If the discussion is to be open, descriptive terms whose definitions classify their referents a priori as erroneous, frivalous or fraudulent must be dismissed as contrary to the purpose of serious investigation I couldn't agree more. Aspheric (talk) 16:27, 16 January 2013 (UTC)

Aspheric comments in numerous talk page sections above that "NSF is a flawed source". NSF is a reliable source. I am therefore creating a talk page section specific to discussion of NSF, and only NSF. (Please read the NSF source in its entirety before commenting.) 64.134.225.194 (talk) 15:28, 16 January 2013 (UTC)

NSF is a non-medical primary source and should receive less weight than secondary sources from core medical journals including BMJ, Lancet, Nature Immunology, Medical Journal of Australia, etc... Please also remove the user name from the heading Aspheric (talk) 16:35, 16 January 2013 (UTC)

Done.Qexigator (talk) 17:11, 16 January 2013 (UTC)

Irrespective of whether this is a reliable source in general, I think it's a problematic source for a definition of alternative medicine. It explicitly says that it's offering a stipulative definition when it says "as used here": "As used here, alternative medicine refers to all treatments that have not been proven effective using scientific methods." Here's what our Wikipedia entry says about stipulative definitions:

A stipulative definition is a type of definition in which a new or currently-existing term is given a specific meaning for the purposes of argument or discussion in a given context. When the term already exists, this definition may, but does not necessarily, contradict the dictionary (lexical) definition of the term. Because of this, a stipulative definition cannot be "correct" or "incorrect"; it can only differ from other definitions, but it can be useful for its intended purpose.[1][2]

It's wrong to use this definition as the primary one in the lead of the article. TimidGuy (talk) 11:53, 17 January 2013 (UTC)

On the contrary, Wikipedia's articles need to stipulate what the article is covering; we require a stipulative definition in the lead.GliderMaven (talk) 16:45, 17 January 2013 (UTC)

Aspheric, please don't remove the section on Ayurvedic medicine and the six reliable sources that support it. Thanks.

The sources that Aspheric removed from the Ayurvedic medicine section he deleted the header for, are -

• Indian Academy of Sciences - Ayurveda: Putting the House in Order
• Journal of the American Medical Association - Lead, Mercury, and Arsenic in US- and Indian-Manufactured Ayurvedic Medicines
• Encyclopædia Britannica - Underwood, E. Ashworth; Rhodes, P. (2008). "Medicine, History of". (2008 ed.)
• Scientific Basis for Ayurvedic Therapies, Lakshmi Chandra Mishra,
• Herbal Supplements: Efficacy, Toxicity, Interactions with Western Drugs, and Effects on Clinical Laboratory Tests * Lead Poisoning Associated with Ayurvedic Medications
• The Roots of Ayurveda: Selections from Sanskrit Medical Writings - D. Wujastyk

64.134.231.145 (talk) 19:30, 16 January 2013 (UTC)

Sources were moved, nothing was deleted. Is this the same editor as 64.134.225.194 ? Aspheric (talk) 19:32, 16 January 2013 (UTC)

The diff provided shows that you deleted the section header, and moved the sources on Ayurvedic medicine to the section on Traditional Chinese Medicine.

Aspheric, you are wrong, Auyrvedic medicine is not a Traditional Chinese Medicine.[40] 64.134.231.145 (talk) 19:46, 16 January 2013 (UTC)

No, look at the diff again. Safety concerns about Ayveda were moved right down to the section 6 (safety)

This is the same editor as 64.134.225.194, isn't it ? Aspheric (talk) 20:33, 16 January 2013 (UTC)

And now we have 158, welcome and thank you for your points about WP:OR ! All these ip's turns the article into an edit war waiting to happen. I'm all in favor of clean starts but disagree with this [41] because it means you can game the system and avoid the consequences. I hope the article improves.Aspheric (talk) 20:57, 16 January 2013 (UTC)

Controversy issues on a specific subtopic should be integrated in to the relevant specific topic section, unless they are so general as to not fit in at that point. It makes no sense to construct an entire parallel article in a series of controversy sections out of context. 64.134.222.106 (talk) 00:53, 17 January 2013 (UTC)

i've left a brief whinge on the ANI noticeboard for anyone who's interested. "why doesn't somebody do something ?!" is probably the silent prayer that every wiki editor mumbles before they go to sleep Aspheric (talk) 22:09, 16 January 2013 (UTC)

Wikipedia:Administrators' noticeboard/Incidents#Is this Socking, ? A block for socking and the page is semi-protected. FiachraByrne (talk) 03:57, 17 January 2013 (UTC)

Interesting FiachraByrne (talk) 03:59, 17 January 2013 (UTC)

i thought i'd made my last edit here and am genuinely surprised by the block and semi protect and the speed of the process. I'm sure my edits aren't perfect and I may have been lucky not to get blocked as well.

At least one admin has sympathy with the ip's and said Alt med terms "shouldn't be sugar coated". To be fair I hadn't considered this, or that legitimising a few good treatments can inadvertantly give authority to many bad treatments.

But to quote another editor here "there is more encyclopedic content to add to the article than merely the public service announcement that alt med is a dangerous fraud/glorious boon to mankind". The current article doesn't come close to resembling any mainstream authorative review of the topic and I find it depressing when i compare it them.

For the record, I do believe 'conventional' medicine has brought us a long way and 'alternative' medicine is mainly placebo but there is sometimes a large overlap between the groups and only part of medicine is about clinical trials. A kind smile and a cup of tea is sometimes worth more than an RCT to the right patient. In this seminal 1927 JAMA paper[42], the author complained that young (medical) graduates were too 'scientific' and noted that 'the secret of care of the patient is in caring for the patient'. I believe any practioner 'must' have a sharp, inquiring mind and a safe and competent approach but poor medical practice is by no means exclusive to alt med, even if it is more common there.

I realise that you can't un-ring the bell but the majority of edits over the last 2 weeks were pushed through by a few ips. All other suggestions were brushed aside or quickly reverted . Some of changes may have merit but none have been properly considered, discussed and intergrated in an appropriate manner. The current article is patronising to the reader and a poor treatment of an interesting topic.

These are my initial thoughts, I would welcome the view of others. I am also happy to step away from the article if people think that would be helpful ? My only real aim is to help the reader find clarity (even if sometimes that means showing them complexity and letting them judge for themselves) Aspheric (talk) 15:59, 17 January 2013 (UTC)

For what little it may be worth, I can be clear that I haven't been a great advocate of all of your edits, but then there were also others which did not entrance me greatly either. That however, is what Wikipedia is - accepting that to develop consensus takes some give and take and that the result may be the least worst outcome rather than the best outcome. I personally believe that the semi protection was not helpful. The edits weren't sugar coating even if they were, at times, radical.

I don't think that the article as it is is acceptable - to be frank it is a dog's dinner - but part of the blame for that must lie in the definition. This envelopes well accepted herbal remedies through prayer and yoga to magnetic quantum holographic oncology (and yes I did invent that but look out for it in the future) under an umbrella description of supernatural, quackery and pseudo science. Much of it is snake-oil but some of it isn't - and that isn't at all clear. It isn't also clear that some main-stream medicine can be just as harmful as the downright quackery. Some modern main-stream medicines may kill you whilst homeopathic remedies only re-hydrate you (although at some unjustified cost). I would drink a cordial of Colt's Foot to ease a cough but I wouldn't strap a magnet to my head (holographic or not). I suspect the remedy is for a well respected editor to draft out a wholly new version in user-space somewhere and put it up for review as a replacement article.  Velella  ^{Velella Talk}   16:35, 17 January 2013 (UTC)

Hear,hear. The only thing that ties this dog's dinner together is that it's not accepted by the powers that be. So we should start with that. Then mention that in the developed West, that's because some of it is supernaturally based. But some parts are not, and not accepted because they have been disproven like Laetrile, or else don't yet have the needed evidence, like dichloroacetate for some cancers. So why can't we just say this? It's a broad tent. Define it first, then do the divisions. SBHarris 06:12, 19 January 2013 (UTC)

The blocking of editors should not be seen as providing a pass on the observation of WP:MEDRS where medical claims are made. The definition of the article is problematic as it is disputed and changes across time and in different contexts. The article should reflect that rather than imposing a non-existent "correct" definition. FiachraByrne (talk) 14:55, 18 January 2013 (UTC)

The blocked editor was indef blocked for first having been blocked for socking under one username, then coming here and later editing under another. That's enough without the IP editing. But all the IP edits this last month, not only the 64. edits but the others also, were this *same guy* too! He was intelligent but causing chaos. It was like pulling teeth to get this info as the check users were not forthcoming, and I had to rely on intuition plus some inside info provided when I got enough of the picture to be asked to let it go. Suffice to say it wasn't alt med persecution. SBHarris 05:44, 19 January 2013 (UTC)

SBH, can you say what you meant by not accepted by the powers that be. Which / what are hostile to "alternative medicine" as named by FDA[43] above at "Present state of alternative medicine in USA" [44]? --Qexigator (talk) 10:12, 19 January 2013 (UTC)

Alternative medicine contains a diverse range or practices and bases. Examples should be given to better inform the user. Images are always helpful to the user, and should indicate the range by including examples from the various regions of the world.

There is an alt med list article, but examples would be helpful here too, as per MOS avoid overlinking when unnecessary.

The current article body is highly uninformative as to the diversity and nature of alt med practices, appearing to be mostly repititions of the words "conventional" and "mainstream" ad nauseum, and about success of the relatively recent massive promotion of alt med, and measurement of the success by "increasing usage".

This leaves the encyclodia user with an impression that there is some vast unconventional and nonmainstream set of practices being used more and more around the world, but wondering what these practices are or may look like.

Please discuss examples and images to include. — Preceding unsigned comment added by 64.134.225.194 (talk) 17:21, 6 January 2013 (UTC)

Good suggestion, pictures of herbs are included at the top and others would be easy to source. The Nature Immunology article has some other graphics that help the reader understand the concepts involvedAspheric (talk) 17:39, 6 January 2013 (UTC)

--64/Starbucks: Editors before you who are looking for improvement of the article may agree with much you are proposing, but if you are now joining in, what about signing in the 4 tilde way anyhow, or using your login, in the conventional/ mainstream/ normal/ usual fashion? Qexigator (talk) 17:46, 6 January 2013 (UTC)

The images at right are more informative, as to what alternative medicine is, than the entire rest of the overbloated article body, which reads more like a "get on the unconventional bandwagon" promotion, than an article about alternative medicine. It would make a nice addition to the end of the lead if it could be arranged horizontally, not vertically, especially if the purpose is to inform the user. Does anyone know how to arrange them horizontally, not vertically? 64.134.225.194 (talk) 18:57, 6 January 2013 (UTC)

Not that informative as images, whoever put them here. For the ordinary reader all but one of them could be illustrating mainstream medical practice (Medicine), and in some traditions the chakra image could be regarded as mainstream. Qexigator (talk) 18:48, 6 January 2013 (UTC)

More full captions were added after Qexigator's correct comment. Image with very minimal captions might not be that informative.

Qexigator's usage of one interpretation of the ambiguoous word, "mainstream", is correct that his usage. But Reiki chakras as a basis for a claim to heal is always alternative medicine. This argues for removal of the word "mainstream" from the article, because of the ambiguity introduced. — Preceding unsigned comment added by 64.134.225.194 (talk) 19:02, 6 January 2013 (UTC)

After being in two minds about the images, have now figured out why: some readers may (unduly?) fancy them and others may see them as ridicule: it's in the eye of the beholder, and makes a balanced comment. Qexigator (talk) 14:25, 10 January 2013 (UTC)

I don't think the images and examples currently being used convey the breadth of the subject or reflect mainstream classifications. I think the idea is good but the current approach is flawedAspheric (talk) 11:21, 13 January 2013 (UTC)

This section has been added without consensus or proper examination. The currently version is poorly structured, poorly written and poorly referenced. The Nature Immunology article provides the following overview

Biologically based complementary and alternative medicine (CAM) approaches include herbal medicines, ‘megadoses’ of vitamins and SPECIAL DIETS107, such as those proposed by Drs Atkins108 and Ornish109. Manipulative and body-based therapies include methods that involve manipulation and/or movement of the body, such as massage, chiropractic and osteopathy. Mind–body interventions use various techniques that are designed to facilitate the capacity of the mind to affect bodily function and symptoms, including yoga, prayer, meditation, spirituality and guided imagery. Energy therapies are intended to affect energy fields (biofields) that purportedly surround and penetrate the human body, using REIKI and therapeutic touch. Alternatively, energy therapies can involve the unconventional use of ELECTROMAGNETIC FIELDS, such as pulsed fields, magnetic fields, or alternating- or direct-current fields. Alternative medical systems involve complete systems of theory and practice that have evolved independently of, and often before, the conventional biomedical approach. Many of these are traditional systems of medicine that are practised by individual cultures throughout the world, such as traditional Chinese medicine (of which acupuncture is a principal component) and Ayurvedic medicine from India, but they also include the more-modern Western approaches that are applied in HOMEOPATHY and naturopathy.

I would suggest we replace the current section with something similar, alternatively, we should re-examine both text and references. Aspheric (talk) 17:54, 26 January 2013 (UTC)

Broadly agree, but would prefer to see rewrite done as an expansion of content in FDA and similar (for reasons given in section Present state of alternative medicine in USA above[45] , with the intent that readers may have a fuller description of what the FDA (and comparable bodies) are talking to the public about rather than scrappy input pushing the narrower topic of Science education as part of a debate local to USA and its education system. That would, as I see it, improve the integrity and coherence of the article as a whole. Qexigator (talk) 18:35, 26 January 2013 (UTC)

The FDA will be more interested in pills and potions than crystals and yoga so they won't give us a proper overview. I've used the Nature Immunology article as a template and included some stuff from the NCCAM website, I'm sure it's not perfect but it's a big improvement on the seemingly random headings that were there before. I'll divide the new section introduction among the subheadings and examine the text more closely when I get a chance. At first glance, the references don't seem to have much to do with the text. Aspheric (talk) 20:32, 26 January 2013 (UTC)

I feel there may be a problem here, but await the result of your present exercise before commenting further. My concern revolves around letting readers who are within the scope (so to speak) of FDA activity, and similar elsewhere, be able to proceed from there to some further detail and limited discussion, and letting them find fuller information in other articles. Or if a reader comes here before FDA info., our first concern is to point out the FDA is there and has that responsibility, and anything anyone else has to say about it, including Medical schools, is subject to that, within USA or (lawyerspeak) as the case may be elsewhere. Qexigator (talk) 21:42, 26 January 2013 (UTC)

To cover what is a gap in the content of the article I have added a section "Medical education". This is what used to be called a stub which will need some tweaking and expansion, but should not be enlarged to the point of UNDUE. Qexigator (talk) 20:51, 26 January 2013 (UTC)

List of definitions below. Please feel free to add definitions of major, representative, medical institutions and health bodies below. Please just provide the definition in the same format as those below without any editorialising commentary. Commentary should be added to the section immediately below. Thank you.FiachraByrne (talk) 08:53, 21 January 2013 (UTC)

Please note - sources should constitute actual published, datable policy documents with attributed corporate and/or individual authors and not simply website blurbs, etc. FiachraByrne (talk) 09:13, 21 January 2013 (UTC)

• British Medical Association

• CAM Research Methodology Conference, April 1995 Panel on Definition and Description^{[n 1]}

• Cochrane Collaboration^{[n 2]}

• European Parliament^{[n 3]}

• The WHO

• National Center for Complementary and Alternative Medicine (US)

.

.

List source below using quote box format shown in Definitions a) FiachraByrne (talk) 23:10, 21 January 2013 (UTC)

• National Center for Complementary and Alternative Medicine (US)

List source below using quote box format shown in Definitions a) FiachraByrne (talk) 23:10, 21 January 2013 (UTC)

List source below using quote box format shown in Definitions a) CAM as pseudoscience, irrationalism, etc, goes here FiachraByrne (talk) 23:10, 21 January 2013 (UTC)

List source below using quote box format shown in Definitions a)FiachraByrne (talk) 00:59, 22 January 2013 (UTC)

List source below using quote box format shown in Definitions a)FiachraByrne (talk) 00:59, 22 January 2013 (UTC)

List source below using quote box format shown in Definitions a)FiachraByrne (talk) 00:59, 22 January 2013 (UTC) see below WHO

List source below using quote box format shown in Definitions a)FiachraByrne (talk) 00:59, 22 January 2013 (UTC)

• The WHO

Primary source (use WHO source in section (a) as secondary)

List source below using quote box format shown in Definitions a)FiachraByrne (talk) 00:59, 22 January 2013 (UTC) Relatively (or partially, or workably) neutral sources that discuss meanings inherent in and implications of different sourcesFiachraByrne (talk) 23:10, 21 January 2013 (UTC)

Please add commentary on above definitions here. FiachraByrne (talk) 09:01, 21 January 2013 (UTC)

Broadly speaking, the consensus across all of these quotes, including the ones I posted above, is that alt med is medicine not traditionally used in a country. What is alt med in one country could be traditional medicine in other countries. This should be what the consensus definition is, not the idiotic "any medicine not backed up by science" we have now, which is at odds with all the quotes above. Wkerney (talk) 04:17, 22 January 2013 (UTC)

Wk: That may be so, but surely the other is not always and everywhere necessarily "idiotic", and probably should be mentioned (unemotively) because it seems to be a supposition or conviction quite widely held, often by persons leaning more to scientific positivism (whether or not as a disciple of this or that notable writer about science) than to a knowledge of reasoning and its fallacies, which, of course is not the topic of this article and would need another place for discussion at length and in depth. Qexigator (talk) 09:22, 22 January 2013 (UTC)

As Qexigator says, what we'll call the scientific viewpoint of alt med is significant and should have significant prominence. Aside from the fact that this is correct, to do otherwise is to invite article instability. You may note that this article has been the subject of edit warring for many years, that editors working on this page have been subject to summary sanctions by the Arbitration Committee since 2008, that this page topic falls within the policy domain of WP:Fringe and the widely observed guideline of WP:MEDRS, and that currently no medically orientated editors or rational skeptics are currently participating in this discussion. So this needs to be done carefully. Having said that, it's clear that the OAM 1995 definition is the most pervasive and influential one and should probably be the first one introduced in a section looking at definitions of the topic. However, its introduction and use will need contextualisation and qualification (as will other definitions). Nor will it be the only definition used. If we treat the sources fairly, in a representative way, contextualise them properly (sources allowing) and do not seek to exclude sources that disagree with our point of view, I think, there may be a better chance of stability. Probably, however, the article is permanently fucked. FiachraByrne (talk) 10:17, 22 January 2013 (UTC)

The Arbitration resulted from a heated debate about Homeopathy:The conflicts presented in this case revolve around homeopathy and various related topics[46]Does it bode so bad for the re-editing of the article now being undertaken? The decision[47] recited certain Principles:

1) The purpose of Wikipedia is to create a high-quality, free-content encyclopedia in an atmosphere of camaraderie and mutual respect among contributors. Use of the site for other purposes, such as advocacy or propaganda, furtherance of outside conflicts, publishing or promoting original research, and political or ideological struggle, is prohibited. OK

2) Wikipedia users are expected to behave reasonably, calmly, and courteously in their interactions with other users... OK

3) Wikipedia articles should rely on reliable, third-party published sources with a reputation for fact-checking and accuracy. Sources should directly support the information as it is presented in an article and should be appropriate to the claims made: exceptional claims require exceptional sources. OK

If that and the guideline of WP:MEDRS are observed by all parties, is the article doomed to be crushed by invoking WP:Fringe as if that trumps the Principles? Qexigator (talk) 11:49, 22 January 2013 (UTC)

--Is Principle 3 of the arbitration ruling quoted above poblematic, referring to "claims being made"? Surely the purpose of an article such as this is not to make claims for or against any medical theory or practice, but to inform readers about the way in which the term "alternative medicine" is used in notable ways. At the present day, the most notable is inevitably, in respect of any given country, published information by or about government bodies and institutions exercising advisory or enforcement functions, including licensing for practice. That can be expanded by describing any public debate about that government's policy or the enforcement activity. There is little need to give more than a brief mention of any particular "alternative medicine" which has been so named by any of the responsible bodies, because if it is notable it has, or could have, its own article. The present exercise here seems to be going in the right direction and making headway. Qexigator (talk) 14:16, 22 January 2013 (UTC)

I am buoyed up by this heady optimism. If the principles, policies and sanctions were effective the article would be balanced, well-written and informative. This kind of article requires an editorial committee of knowledgeable/expert editors that could evaluate content in a neutral fashion. Anyhow, we persevere without hope or expectation. FiachraByrne (talk) 19:48, 22 January 2013 (UTC)

Zollman and Vickers in their 1999 BMJ article don't properly reference from whence they've derived that Cochrane Collaboration definition. Does anyone know the original citation for it? FiachraByrne (talk) 10:35, 21 January 2013 (UTC)

Not sure I think that they're just acknowledging that Cochrane use the IOM def (as SBHarris pointed out before). To their credit, Cochrane have been relatively consistent on this point. Their 2011 paper again quotes the IOM as the "most widely accepted definition" box 1 but it seems for practical purposes, they are more interested in operation definitions (see same paper). Aspheric (talk) 12:40, 21 January 2013 (UTC)

Other sources say they "adopted it" but never cite an actual Cochrane paper. Will require more digging. Can you find SBHarris's comments from the archive? FiachraByrne (talk) 13:01, 21 January 2013 (UTC)

SBHarris's point: [48]. They quote it and then outline operational definition. Hmm. FiachraByrne (talk) 13:14, 21 January 2013 (UTC)

Zollman and Vickers (1999) state that this is the definition "used by" Cochrane and "adopted by" Cochrane (without citation). Everyone cites Zollman and Vickers on Cochrane adopting this this definition. We need a paper/statement from Cochrane from 1999 or earlier in which this definition appears. FiachraByrne (talk) 13:19, 21 January 2013 (UTC)

The Cochrane CAM Field was founded in 1996; they must have had some working definition at that point and it seems plausible that they may have adopted the definition of the 1995 panel, at least at that point. Needs a source though. Zollman and Vickers are insufficient.FiachraByrne (talk) 13:35, 21 January 2013 (UTC)

Probably in the NIH Cochrane minutes of proceedings; possibly unpublished; certainly not on the internet. FiachraByrne (talk) 13:41, 21 January 2013 (UTC)

The 3 quotes above are from 1995, 1999 and 2004. Such a sequence may be happenstance but presumably indicates a progressive sequence of some kind. Has a later source acknowledged expanding, narrowing or otherwise varying an earlier? Is there any other source which accounts for this? Qexigator (talk) 11:20, 21 January 2013 (UTC)

Good question. It's not random. There's a definite change in the 1990s (BMA reversed position in 1993 from 1986; BMJ published article in 1999 was celebratory). Probably ties into mantra about consumer choice, economic incentives, reorganisation of medical services, diminishing authority of the medical profession, cultural changes - but dunno about sources yet. FiachraByrne (talk) 11:28, 21 January 2013 (UTC)

Park commented on many of these sources (amongst many others) previously. People may want to revisit that thread: Talk:Alternative medicine/Archive 21#Sources for the rewrite of Lede required by WP:MEDRS, WP:NPOV, WP:MOS (lede), and WP:FRINGE. FiachraByrne (talk) 13:01, 21 January 2013 (UTC)

My favourite comment from recent archive [49] FiachraByrne (talk) 13:09, 21 January 2013 (UTC)

Perhaps we could include the softball metaphor ?! SBs points seem reasonable: alt med is a very broad term and the term "healing resources" is not widely used. Park's list doesn't stand up to basic scrutiny: sources 1,3,4 do not offer a conventional definition and source 3 is non medical. Source 2 is a news report of the establishment of a alt med research institute. I couldn't find the quote offered in the text. 5&6 aren't cited or authorative. 7&9 are book reviews and again don't support the current lead. 8 is a good source which accepts and critiques the IOM def. 10&11 aren't cited. The view of 12-15 (WHO,BMJ,Cochrane) as difficult to read / non-authorative / marxist conspiracy is simply bizarre and a poor attempt to descredit the best material available.Aspheric (talk) 17:10, 21 January 2013 (UTC)

Many sources state that there is no satisfactory definition and CAM or alt med is a broad church. That point should go in and will be easily supported. I think Park tried to exclude a lot of sources on spurious grounds. For something like alt med, which cuts across legal and political realities, political definitions are very relevant to its status. However, I don't want to exclude those sources that define it on scientific grounds or as lacking an evidence base - they also constitute an important perspective. Part of the problem is the reliance on preferred and exclusionary definitions. I'm going to provisionally propose definitions across multiple domains drawing from this paper [50]. It's not necessarily the best paper of its type but I think a good starting point and reasonably objective (in fairness I've only read a few sections in detail). FiachraByrne (talk) 22:51, 21 January 2013 (UTC)

Just a couple of brief comments - "do not offer a conventional definition" presupposes that one already has a conventional definition. :-) Also, someone like Carl Sagan is generally very authoritative on these issues, same as Gross and Levitt. And so forth - I've made various comments about this in the archives. Arc de Ciel (talk) 03:45, 22 January 2013 (UTC)

1,3 and 4 do not attempt to define the topic in the conventional sense of the word 'definition'. Aspheric (talk) 18:14, 24 January 2013 (UTC)

3 and 4 are not being directly cited for the definition. I would also point out this [51] [52] [53] exchange, starting from the second paragraph of my first comment. :-) Arc de Ciel (talk) 09:08, 26 January 2013 (UTC)

Hi (shouldn't that be arc en ciel?) I'm sure it's a pain but it would be handy if you could link to some of your previous comments on Sagan, Grosse and Levitt in the archives. There's no satisfactory definition and unlikely to be when the very nature of the field is so thoroughly contested at every level; also complicated by instability of CAM's position within/without medicine (institutionally defined). I think it makes sense to go with a kind of historically informed "definition" initially. Leading then with 1993 BMA and 1995 OAM definitions but not purporting that they are statements of what alt med is but rather as a way of introducing widely referenced and recognised definitions and also as a way of introducing the general problem of definitions (which, of course, the article itself can't pretend to resolve). Or something like that. FiachraByrne (talk) 22:26, 23 January 2013 (UTC)

Arc de Ciel (arc of sky) is intended, but I also own the name Arc en Ciel (arc in the sky/rainbow) and was thinking of a name change at some point. :-)

Since I'm really trying to minimize my time spent on Wikipedia right now, let me just point out this comment I made to Qexigator above. (Actually, on second thoughts I think it may have been somewhere else I had that discussion anyways.) ETA: Though I should have chosen my words more carefully. Of course there are stronger sources, e.g. direct statements from respected scientific organizations - I was responding to a general question, and it's rare that we have such statements. The overall point is that their work generally describes the scientific consensus on fringe topics, and tends to be the place (sometimes the only place) where this is actually published. For myself, I don't feel strongly about what the first sentence is, as long as the rest of the lead continues to communicate the same points that it already does. That said, it could communicate those points quite a bit effectively as it is rather long-winded at the moment - And of course, it seems that some editors do feel strongly about the first sentence. Arc de Ciel (talk) 09:08, 26 January 2013 (UTC)

Well, that comment from recent archive [54]) is a lot of outspoken words but presumably the commenter would not claim to have originated that not unusual point of view. Among those of the regulatory bodies of USA and elsewhere, and other members of the populations around the world who have given thought to these questions, it may be that a considerable proportion are of a similar conviction. If supported by acceptable sources it would have a place in a criticism section. In fact it has been around for so long that maybe it could be part of a History section. It seems to have little to do with advancement of current knowledge. Qexigator (talk) 14:34, 21 January 2013 (UTC)

I'm not advocating for the inclusion of SBHarris's comments (how?). I just like them. What's added to this article is basically going to have to be boilerplated to have any chance of sticking. FiachraByrne (talk) 16:22, 21 January 2013 (UTC)

Understood, and agree about Copper-bottomed sources as now progressing. But must admit had to look up Boilerplate (text) to tell the difference from Boilerplate code, again proving the value of Wikipedia for communicating information to the supposedly educated but undoubtedly old-fashioned (of the forward looking school). Cheers! Qexigator (talk) 16:59, 21 January 2013 (UTC)

With regard to the CAM definition attributed to Cochrane by Zollman & Vickers (in BMJ, 1999); this same definition is attributed to the Office of Alternative Medicine (1995) and to the Institute of Medicine (2005) in this source.Puhlaa (talk) 17:52, 21 January 2013 (UTC)

Thanks. Added detail that OAM constituted expert panel for 1995 definition (contained in note 1). Didn't add Institute of Medicine as I can't find a proper reference for this. FiachraByrne (talk) 21:47, 21 January 2013 (UTC)

And the lead author for that OAM 1995 definition appears to have been Bonnie Blair O'Connor. FiachraByrne (talk) 22:21, 21 January 2013 (UTC)

Adoption by Institute of Medicine also appears in multiple sources. FiachraByrne (talk) 22:29, 21 January 2013 (UTC)

Noted that Cochrane Collaboration, n2 limks to "Complementary and Alternative Medicine in the UK and Germany - Research and Evidence on Supply and Demand" (2003). Conclusion on p.x identifies "the key policy issues in health care" as: "quality, consumer protection and cost containment, professional regulation, equity of access, reimbursement and contracting arrangements" and remarks that these are also important in the CAM market, and that there had been a lack of systemic, reliable and comparable data identified by the report. Published by Anglo-German foundation for the study of industrial society, inc. by royal charter in 1973.[55], closed in December 2009 following expiry of Charter[56]. Qexigator (talk) 00:18, 22 January 2013 (UTC)

Qexigator, can you outline the significance of this for me? FiachraByrne (talk) 00:51, 22 January 2013 (UTC)

If the link in Note 2 has a purpose, it is to enable us to inspect the content at the linked site. If use is to be made of it we would need to know something about it. That is what I found. If it is not to the point, why the link? Qexigator (talk) 01:05, 22 January 2013 (UTC)

Gotchya - I didn't follow the reference to note 2. OK - I just included that there because of the suggestion that Cochrane had not adopted the whole definition advanced by Bonnie Blair O'Connor & the OAM panel in 1995. It's an interesting paper but that the organisation is defunct is, perhaps lamentable, but of no great moment for this article methinks. FiachraByrne (talk) 01:39, 22 January 2013 (UTC)

It may be useful for editors meantime, but maybe would not be used as source in the article? Qexigator (talk) 02:00, 22 January 2013 (UTC)

Depends on what it was being used for, I guess. It summarises quite succinctly some of the different positions on definitions and I've used it, in part, for the provisional categorisation of definitions by domain above. The bar for inclusion of sources will in part be determined by how objectionable different editors perceive the prospective added content. But at the moment I'm just using it as a disposable guide. Short answer: no, not likely and probably not needed. FiachraByrne (talk) 02:06, 22 January 2013 (UTC)

The definition of CAM as "a broad domain of healing resources" is evidently the most pervasive in the literature as shown in a simple google scholar search which returns 253 results [57]. Not all endorsements, of course, but there's little doubt it's the most common reference point. Its inclusion, in whole or in part, should be contextualised - if a good source or sources can be found - outlining context of its production (who, what, when, why, etc). FiachraByrne (talk) 02:10, 22 January 2013 (UTC)]

For the record, comments made on my talk page by IP editor regarding my statement above that 1995 OAM definition is the most pervasive [58]; Qexigator's response [59]; my response [60]. FiachraByrne (talk) 22:32, 23 January 2013 (UTC)

Decent history on the establishment of the OAM at least: James Harvey Young (1998), "The Development of the Office of Alternative Medicine in the National Institutes of Health, 1991-1996", Bulletin of the History of Medicine, 72(2):279–298. FiachraByrne (talk) 02:28, 22 January 2013 (UTC)

Added WHO integrative/inclusive/tolerant definitions above. Fiachra has taken a very thoughtful and professional approach and hopefully this effort will avoid us having to revisit this issue. Still, we are not writing an academic paper or a consensus statement and we should not split hairs when the current article is in a bad state. When in comes to writing the lead / terminology section, I think we should keep the text clear and engaging and never use a big word when a small one will do, even if sometimes that means losing some academic precision.Aspheric (talk) 20:34, 23 January 2013 (UTC)

Agree re use of plain language. Writing another article at the moment. Will be back here tomorrow hopefully. FiachraByrne (talk) 22:11, 23 January 2013 (UTC)

Plain language and academic precision are different things, though. Don't actually introduce false statements. :-)

And for the record, I wouldn't say that the article is in that bad a state. (It wasn't before the recent overhaul either - it's always been well-sourced, reasonably comprehensive, etc.) It's just that improvements are always possible, which is the state of most articles at all times anyways. Arc de Ciel (talk) 06:05, 24 January 2013 (UTC)

I think the point is that the language used should be clear and not unnecessarily technical; no-one is advocating the introduction of false statements (well, limited by sources there). As regards article quality, I'll concede that there are lots of citations and there are certainly articles in a much worse condition. FiachraByrne (talk) 09:02, 24 January 2013 (UTC)

The article is Fubar because it was flooded with changes by a socking editor. It is ironic that some edits advocated a "scientific" standpoint while taking a distinctly "lazy and unscientific" approach i.e, selective citation, misquotation and misinformation. Despite a wealth of well thought out and beautifully written criticism available within the scientific literature, edits would often state a controversial view and then attribute them to an unrelated source. I agree that an expert editorial board would be the best solution but since that isn't going to happen it would be nice to correct some of the more outrageous statements not just because it is an unfair treatment of the subject but because it gives those with a scientific viewpoint (including myself) a bad name for not challenging such an amateur hatchet job Aspheric (talk) 18:14, 24 January 2013 (UTC)

1_The quote from HL 6th report, 2000:"...Some medical schools are now offering CAM familiarisation courses to undergraduate medical students while some also offer modules specifically on CAM..."

• Is any further information about this available?

2_Complementary Medicine: New Approaches to Good Practice BMA report (OUP, 1993). The link shows a page which includes Orthodox medicine occupies a position of power and dominance over alternative medicine, as illustrated by the definitions of alternative practices offered by professional organisations such as...BMA.. (p.48, "Understanding Health").

• Looking to see whether this has relevance to some part of the article in connection with the controversy in principle.

Qexigator (talk) 16:22, 29 January 2013 (UTC)

On controversial articles editors often focus on the lead to the detriment of the rest of the article. I'm sure a lot of editors could identify problems with the current lead but, in my opinion, the best way to fix those would be to focus on the body of the article first and only revisit the lead when that has reached a satisfactory outcome.

Leads should summarise the article and, ideally, should not require masses of citations. However, if editors simply focus on changing the existing lead – throwing in definitions of alternative medicine without regard to how they cohere with the rest of the article or as measure to counteract current definitions which they find unpalatable – things will quickly descend into an edit war.

In my opinion, the first section of the article (that is the section below the lead) should spend some time defining the topic and recognise that there are multiple definitions of Alt Med some of which are quite polemical but which should still be included. FiachraByrne (talk) 17:58, 18 January 2013 (UTC)

Currently, the lede is horrible. It should be fixed immediately, as people around the world repeat the incorrect definition used here on wikipedia. Altnerative medicine is NOT anti-science, or claims which are not represented by science. There are thousands of papers on the efficacy (or lack thereof) of various alt med remedies, which is why organizations like UCSF (which has the top pharmacy school in the world), the FDA, the NHS and so forth do not use that definition. Wkerney (talk) 15:44, 20 January 2013 (UTC)

Broadly agree, but subject to "Present state of alternative medicine in USA" above [61]. The revised first sentence from FDA makes a good start, but could be placed in the first section if preferred. Qexigator (talk) 18:09, 18 January 2013 (UTC)

Great. Edit war over lead now in full swing. FiachraByrne (talk) 00:15, 19 January 2013 (UTC)

Perhaps not.Qexigator (talk) 00:30, 19 January 2013 (UTC)

OK. I think that putting it there for the moment is much wiser and offers the possibility of thrashing out the relevant definitions without getting into endless edit-revert cycles. FiachraByrne (talk) 02:22, 19 January 2013 (UTC)

War, huh, yeah, what is it good for ? Absolutley Nothing - Edwin StarrAspheric (talk) 13:00, 19 January 2013 (UTC)

Not forgetting that at least one experienced editor regards the lead as "bloated".[62] --Qexigator (talk) 12:00, 19 January 2013 (UTC)

There also appears to have been an undue emphasis on "anti-science" and "propaganda", such as IP Revision 22:54, 4 November 2012 - 108.226.165.226 (Sourcing from body of article in Annals of the New York Academy of Sciences issue on "The Flight from Science and Reason", medical science article: ANTISCIENCE TRENDS IN THE RISE OF THE ‘ALTERNATIVE MEDICINE’ MOVEMENT)[63] --Qexigator (talk) 13:20, 19 January 2013 (UTC)

I would agree that some (many) arguments have been overly dogmatic and tend to be reliant on single sources. From my perspective, the article appears to be significantly US centric, but this maybe because of the wider availability of sources particularly internet sources. There are however others such as [64] which , amongst other things, demonstrates that the NHS can be worryingly catholic in the range of medical practices it espouses.  Velella  ^{Velella Talk}   14:55, 19 January 2013 (UTC)

As I see it from UK perspective, there is a case for USA centric but not exclusive of UK and other countries: see Reason above.[65] Qexigator (talk) 16:41, 19 January 2013 (UTC)

Vel, could you please explain worryingly catholic? Qexigator (talk) 17:08, 19 January 2013 (UTC)

I am very tempted to reply I guess you know very well, and so would others but, since that phrase has already been overused on this page, I will simply confirm the dictionary meaning of catholic - as in Of broad or liberal scope; comprehensive [66]  Velella  ^{Velella Talk}   19:30, 19 January 2013 (UTC)

Vel, I certainly do not pretend to ignorance of that dictionary definition and you did well to resist the temptation. My concern is, what do you want us to understand by saying it is "worryingly" so. Why need we be worried about it for the purpose of the article? Qexigator (talk) 20:08, 19 January 2013 (UTC)

Worryingly for me, as somebody steeped in science, when the health system, of which I am proud to be a member, also espouses Homeopathy and other alternative medical practices as a limited part of its mainstream health provision (cf the link given above). This makes agreeing a definition of what is alternative medicine rather more irksome when the apotheosis of Alternative medicine pops up apparently as part of mainstream medicine. Hence my concern about definition. For the sake of clarity, I am not suggesting that because the NHS provides a service then that service is de facto mainstream medicine - far from it - but it does mean that the definition needs to encompass the reality of life in medicine across the globe.  Velella  ^{Velella Talk}   20:18, 19 January 2013 (UTC)

Thanks for that helpful clarification. Cannot reply more fully at this time, but hope to fairly soon. Cheers! Qexigator (talk) 20:27, 19 January 2013 (UTC)

--The panel at the top of the page advises us to use it for discussing improvements to the Alternative medicine article, and not as a forum for general discussion of the article's subject. There is also a notice about other WikiProjects: Skepticism, Peudoscience and Alternative views. That is not an invitation to slant the article in any of those directions or to overload it with information or comment which is better placed elsewhere. A conviction hostile to the practice or use of homeopathic or other remedies, for instance, which bases itself on scientific positivism or anything else (say a position equally faithful or loyal to a religious teaching or political ideal) may be difficult to reconcile with editing some aspects of an article such as this, interesting though it could be to have a reasoned debate about them. Qexigator (talk) 23:29, 19 January 2013 (UTC)

Instead of making a fresh attempt to cure one or more of the defects in the lead at this stage, I have expanded the top of the first section, and this will need some fixing and other edits (but not instant reverts please). If it needs a separate heading, what would it be? Qexigator (talk) 17:42, 20 January 2013 (UTC)

Hi! I agree that it needs a separate heading, since it doesn't really contain information on "examples and classes of alternative medicine," except incidentally. However, we already have a section titled "Use and regulation," and it seems to me like your information fits better under that topic (FDA document under "regulation," NHS info under "use"). I've split and moved it - please let me know what you think. (We would probably also want to summarize the discussion on the FDA document and include other organizations per concerns on weight.) I could also see putting it in a new section called "Consumer guidance" or something similar, but I'll let other editors comment on that first. Arc de Ciel (talk) 02:08, 21 January 2013 (UTC)

Edit: I'm not trying to say the top section shouldn't be expanded or that your additions were unhelpful. It just doesn't seem to me like the information you added fits in that section, and there's already a section where it looks like it does fit. Arc de Ciel (talk) 02:24, 21 January 2013 (UTC)

OK Arc: it's good to see editors are collaborating again to sort out the content, sources and all. I'm likely to be stepping back awhile, unless it gets stalled. Cheers! Qexigator (talk) 09:34, 21 January 2013 (UTC)

Agreed. Cheers! :-) Arc de Ciel (talk) 03:45, 22 January 2013 (UTC)

Arc: In a later section you comment someone like Carl Sagan is generally very authoritative on these issues. Two points: 1_"like"- would you name others, and if so can you name the genre? 2_The remark seems ironic, which could be risky in a discussion here (Tomcat?). Qexigator (talk) 09:02, 22 January 2013 (UTC)

I wasn't being ironic; the genre I was referring to is fringe science broadly speaking, and the group of people is science educators - e.g. another example would be Michael Shermer. I also mentioned Gross and Levitt in my comment. There are, essentially, no sources of higher reliability when discussing (for example) the scientific consensus on fringe topics, including how much evidence there is and whether the topics are science or nonscience. (Unfortunately, there seems to be a conflict in that parts of the medical community are accepting or at least tolerating some forms of alternative medicine, leading to the current conflict.) The current definition ("not based on the scientific method") doesn't have to be the definition, but the strength of sourcing we have is much more than sufficient for us to present it or something similar as a prominent, unqualified statement. Arc de Ciel (talk) 06:05, 24 January 2013 (UTC)

Thanks for making that clearer. A dificulty as I see it is that questions around scientific positivism and self-proclaimed skepticism go deeper and further than some of their proponents may be aware. What are deemed as in or out for sources can be problematic. It seems odd, for example, that Carl Sagan continues to be treated as if an oracle. Surely it is well enough known not to be a secret that the position of distinguished leading practititioners in the fields of scientific research are not all as dismissive as others about the limitations of scientific theory and practice as a basis for public and private decision making and choice. The FDA seems to be more aware of reality than some popular writers may be. I am afraid I know nothing more about Shermer than I see in the article about him, which does not make him out as being worthy of any special credence on these matters, except as a skilled publicist in USA. It could be argued that phrases like "scientific consensus on fringe topics" tend to be used to set, confirm and advance an agenda in a way which itself is irrational and anti-scientific.Qexigator (talk) 11:16, 24 January 2013 (UTC)

--...and thinking on about your mention of "science educator":

_First, ought we not ascertain what that is commonly understood to be about? There is a Wp article with the title Science education in the sense of sharing science content and process with individuals not traditionally considered part of the scientific community. The target individuals may be children, college students, or adults within the general public, mainly in schools. (As so often with definitions the first sentence seems to be circular, but at the same time imprecise by using the fudgy word "traditionally".) The topic is a part of a larger field connected by many links and subtopics such as Philosophy of science, Scientific openness and Critiques of scientific method, Scientism and Science studies.

_Secondly, how much of a bearing does that have on the Alternative medicine topic? And the answer is perhaps not much. Whether or not there are deficiencies in that branch of education, the article's topic can be seen as: among the population of any given polity, such as USA or any other country, what is regarded as Alt.m. and how is it manifested there?

It is simply going off topic to introduce content about, or based on, the topic of science education, except by way of "See also". There are other more likely topics: hygiene education, physical fitness, lifestyle education and so on all of which have at least some important bearing on health and medicine. But as things are, bodies like the FDA have decided to use the term alternative medicine and publish their advice and infiomation to the public about it. A's idea of Alt.m. may not be B.'s, even when they agree that it most definitely is not C's. In the meantime the FDA has a job to do and as time goes by may vary what it treats as Alt.m. That leaves Wp editors with a job of tracking that so as to be up to date with changes as they happen, and with current notable criticism. Qexigator (talk) 22:55, 25 January 2013 (UTC)

I'm not sure what you're getting at. Sagan/Shermer/etc aren't treated as oracles, just as good reliable sources within their field. (I'm also not sure how you got the word publicist from Shermer's article.) The scientific consensus on fringe topics reflects the most accurate human understanding on such topics; that doesn't preclude it (or the person describing it) from being wrong, but describes the current state of the evidence. With regards to science education, it is relevant to any fringe science topic to the extent that it describes issues such as those I mentioned above (level of scientific support, etc).

Also, the US FDA does not endorse alternative medicines to be effective. As you can see in their "Guidance for Industry" document, the scope of their regulation is defined by the intended use of a product and not whether there is convincing evidence. (They also regulate cosmetics, medical devices, etc.) These are the medicines that the FDA has approved as evidence-based, along with the specific approved formulations, dosages, methods of delivery into the patient, etc. Arc de Ciel (talk) 06:41, 26 January 2013 (UTC)

Thanks for that. To me (a latecomer to this article, after the merger a few months ago from a wider world of skies and rainbows) it's becoming clearer that some may see the remark "scientific consensus on fringe topics reflects the most accurate human understanding on such topics", in the wider context of knowledge, as a fringe type of assertion in itself. It does seem that for this article, the citations of Sagan and the like are no more than marginal, though might be relevant to a brief section about "Science education". The FDA expressly makes known that its advisory information does not endorse, but nor does it condemn in toto, only to the extent that, like other medical practises and products about which it makes warnings, it is harmful or worse, as discussed above at QuackWatch and NPOV#Present state of alternative medicine in USA. But if no reply at this time, understood only so much time is available. Qexigator (talk) 10:30, 26 January 2013 (UTC)

Just to say - the primacy of scientific consensus is not fringe on Wikipedia, at least for any statements that are subject to scientific analysis. :-) But thanks for understanding my time constraints. Arc de Ciel (talk) 11:20, 26 January 2013 (UTC)

Thanks for clarification. Please don't take this comment as captious or point scoring (complete waste of our time here). It would be regrettable to me as one who values much in Wikipedia to discover that articles about medicine have come under a rubric derived from mistaken beliefs about science as a closed discipline, which lacks a basis that sceptically rational persons in the wider community of intelligent discourse would find acceptable for writing an encyclopaedia. I would be loath to be required to accept that.Qexigator (talk) 11:49, 26 January 2013 (UTC)

As noted below, Integrative medicine is mostly a quote from an article by Arnold S. Relman. I think it would help inquirers and editors to add to the top of Intro.(current version), below Jutte:

Arnold S. Relman has remarked that in the best kind of medical practice, all proposed treatments must be tested objectively, and that in the end there will only be treatments that pass and those that do not, those that are proven worthwhile and those that are not. He asked 'Can there be any reasonable "alternative"?' {add citation}

As an academic of noted distinction in the discipline of medicine, which is central to the topic of this article, his remarks (not necessarily conclusive) can only be seen by anyone, including an upholder of "integrative" or "alternative medicine", as much weightier than Sampson, Barrett or most others, and alongside Cochrane and the proponents of EBM. I would say it pinpoints the main issue. Qexigator (talk) 10:29, 7 February 2013 (UTC)

--...and to add Roberta Bivins (Associate Professor, University of Warwick, Director, Centre for the History of Medicine) at top (above Jutte), moved up from end, thus:

Introduction

Alternative medical systems can only exist when there is an identifiable, regularized and authoritative medical orthodoxy, such as arose in the west during the nineteenth-century, to which they can function or act as an alternative. {cite} According to Robert Jutte, labels used to describe health belief systems other than modern, scientific, Western medicine, are either misleading or carry semantic load, as for example "alternative", "marginal", "fringe", "unorthodox" or "irregular",[9] and historians have had some difficulty simply to name and describe without connotative judgement. Jutte found that in the period from the mid-nineteenth century to the first two decades of the twentieth, the opposition of modern, scientific medicine in Germany had resulted in the threat from homoepaths, naturopaths, mesmerists and other healers being stemmed by legal and organizational measures taken by the developing medical establishment..[10]

Arnold S. Relman has remarked that in the best kind of medical practice, all proposed treatments must be tested objectively, and that in the end there will only be treatments that pass and those that do not, those that are proven worthwhile and those that are not. He asked 'Can there be any reasonable "alternative"?' {add citation}

Alternative medicine is put forward .....

Qexigator (talk) 17:40, 7 February 2013 (UTC)

Done, 10:25, 8 February 2013[67]: "expand lead by adding to Intro. para. 1- Bivins (moved from end) and Relman (per Integrative medicine)." Qexigator (talk) 11:26, 8 February 2013 (UTC)

Much above this section proposing leaving the lead alone for a while was passing comment or inconclusive discussion about the sources in the lead. Items which may be for carrying forward are:

1_Two inconclusive discussions about:

_ "spiritual" under Please don't remove terms from sources - "Antiscience" or "supernatural".

_Ayurvedic medicine.

2_The linked article for homeopathy says "Dilution usually continues well past the point where none of the original substance remains". Put briefly, per that source: 'Homeopathy was developed prior to knowledge of the theory of molecules and basic chemistry, by which it has been proved that its remedies use dilutions well past the point where no molecule of the original substance remains.'...the wording of the sentence about homeopathy and dilution is scientifically inexact and needs some minor rewording per Ernst and other source mentioned above... (per Qexigator 10 and 11 January). Qexigator (talk) 20:32, 20 January 2013 (UTC)

The lead Catholics aside, the reason I (and others) started with the lead is because it stuck out like a sore thumb after an earlier bout of tendetious editing. Following the IP edits, the whole article now has problems.

Scientific Approach The topic is difficult to define but that's why we had a terminology section (most similar articles do as well). I have suggested using mainstream reviews (BMJ, Nature Immunology) as templates but some object because (a) disagree with the mainstream medical consensus, (b) believe these reviews have been influenced politicaly or (c) believe the measured language of scientific paper doesn't convey the danger posed.

Consensus Points Most of us agree (a) the article is poor following the ip edits (b) alt med is mostly placebo but some remedies (e.g herbal) have value and evidence (c) alt med is inexplicably popular. Some of us believe (a) that there's more to medicine than just science and (b) for minor ailments, a bit of massage or herbal tea isn't a bad option particularly when medical interventions are potent and not without risk[68].

Options

*1. Revert to 1st Jan or 1st Nov - the article wasn't perfect but it was better than now

*2. Create article called 'Criticism of Alt med' where the critics can go to town

*3. Use mainstream scientific paper as a template

*4. Ask senior editor to rewrite - great idea but assumes someone is willing to rewrite the entire article and won't automatically be derided as biased pro/anti science puppet once they've produced their compromise.

*5. Edit war

I've listed the options in my preferred order. If anyone has any other ideas, then add them to the list. Editing would be a lot easier if we went purely by sources and got rid of this imagined 'science / anti-science' divide but i was naive to suggest this. Most of the medical reviews are clear, easy to read and describe the topic beautifully. I'm very happy to e-mail any article to anyone who would find this useful. Aspheric (talk) 22:35, 20 January 2013 (UTC)

Response to Options

1 Revert to 1 Jan or 1 Nov = Instant rerevert; editwar

2 POV Fork

3 Yes - depends on the paper

4 No one is volunteering

5 The norm - any solution is going to have to avoid this; therefore there's a need to build consensus amongst proponents/detractors/others about the article; consensus is only going to emerge with an article that reflects a wide range of opinions on the topic.

I would favour starting with the problem of definition. People should start listing decent sources that offer definitions of alt med. That should be the first step. We can then evaluate those sources and definitions and see how we can incorporate the spectrum of notable perspectives. FiachraByrne (talk) 23:27, 20 January 2013 (UTC)

That looks to me like the way to go now, but on the whole sources for this topic are not my forte so must leave such listing to others who are likely to make a better job of it. Qexigator (talk) 00:14, 21 January 2013 (UTC)

We'll struggle to find any source that doesn't define it as "Not conventional medicine" or "Any medicine that's not practiced by MDs or taught in med school". Even the NSF source that caused so many arguments quotes the American Medical Association definition as "neither taught widely in U.S. medical schools nor generally available in U.S. hospitals."

The point regarding the need for a 'convention' in order for an 'alternative' to exist is also important, as is the difference between the theoretical (see above) and operational (lists of CAM therapies) definitions.

The problems with the above definition is summarised nicely in paragraph 4 of Coulters MJA article (refs 5c and 26)[69] and should be included in any terminology section:

• To term the group of modalities alternative may be to claim too much for their role in healthcare, but to term them complementary may make their role seem secondary to primary medical care.
• To call them integrative implies some process in which integration or convergence will eventually occur.
• Last, but not least, to define them in terms of “otherness” — that is, by what they are not (as in “not taught in medical schools” or “not practised by conventional medicine”) — is arguably useless. We do not define allopathic medicine by what it is not. Aspheric (talk) 00:25, 21 January 2013 (UTC)

(edit conflict) Anyone can research these. Start with official bodies which have a reasonable claim to representativeness, like the WHO, FDA, etc. They're likely to have a fairly bland, broad and inoffensive definitions. This will allow for a definition at the broadest level. Then work our way down to the more contentious stuff. It would be good to not restrict ourselves to the US and UK but to research Australia, Canada, New Zealand, France, and Germany as well at a minimum. FiachraByrne (talk) 00:30, 21 January 2013 (UTC)

@Aspheric - it's likely that something like that ("non-conventional") will be the first element of the definition. The critique of definitions should be secondary and subsequent (although the observation that alternative medicine is necessarily a dependent category of mainstream medicine is an obvious one). FiachraByrne (talk) 00:35, 21 January 2013 (UTC)

Here are definitions for alt med used by the world's top medical organizations.

The FDA - "The term "alternative medicine” encompasses a wide array of health care practices, products, and therapies that are distinct from practices, products, and therapies used in conventional medicine". (http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm207747.htm)

The NHS says "Complementary and alternative medicines are treatments that fall outside of mainstream healthcare." (http://www.nhs.uk/Livewell/complementary-alternative-medicine/Pages/complementary-alternative-medicines.aspx)

The NIH defines it by saying "Complementary and alternative medicine (CAM) is the term for medical products and practices that are not part of standard care." (https://www.nlm.nih.gov/medlineplus/complementaryandalternativemedicine.html)

The WHO defines it as "a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system." (http://www.who.int/medicines/areas/traditional/definitions/en/)

Additionally, all of them acknowledge that scientific research may (or may not) back up alternative medicine treatments. Follow the links, or read articles such as this: http://www.who.int/mediacentre/news/releases/release38/en/ This means the current definition ("alternative medicine is medicine not backed up by science") should be thrown out and replaced with the consensus definitions above. The current lede is biased and inaccurate. Wkerney (talk) 04:28, 21 January 2013 (UTC)

Thank you for researching some sources. Forget about the lead for the moment. Any statement on the scientific validity or lack thereof of alt med will be a point of contention and will undoubtedly need to look at a wider range of sources. For the moment, the point is to look at the least contentious points of a possible definition. It might also be helpful at this point if we had some input from wikirational type editors. FiachraByrne (talk) 08:38, 21 January 2013 (UTC)

Proposal to OMIT items from Criticism section:

• all now in sub-section Misleading use of terminology.
• in the remainder of Criticism, 7 other items of personal opinion: Sampson, Dawkins, four unnamed Nobel Laureates (re: funding), Salzberg and unnamed others (re: funding), Sampson, Barett, Barrett, a group of prominent scientists (unnamed, re:funding).

Reason for omitting: The more I have been revising the article, the more the parts about terminology read as if from a dispute among various rival sectaries or advocates, at least some of whom may also have an eye to prospects of funding, such as was mentioned by the late Carl Sagan:

'Defending his activities in popularizing science, Dr. Sagan said in another interview: There are at least two reasons why scientists have an obligation to explain what science is all about. One is naked self-interest. Much of the funding for science comes from the public, and the public has a right to know how their money is being spent. If we scientists increase the public excitement about science, there is a good chance of having more public supporters. The other is that it's tremendously exciting to communicate your own excitement to others. [70]

Qexigator (talk) 15:35, 4 February 2013 (UTC)

I'm not following you. Please clarify the following:

Reason for omitting: The more I have been revising the article, the more the parts about terminology read as if from a dispute among various rival sectaries or advocates, at least some of whom may also have an eye to prospects of funding, such as was mentioned by the late Carl Sagan:

--Harizotoh9 (talk) 02:47, 5 February 2013 (UTC)

What's the prob.? Quote from Sagan is clear enough, and if you look at the personal opinions named above, some are openly about Federal funding, per Sagan. That's OK as part of the Federal lobbying system (I hear, not my country) but does not inform readers about the article topic other than about the lobbying process. Why does the reader need to be told about it here?Qexigator (talk) 09:00, 5 February 2013 (UTC)

Omitting from Criticism as at[71] 10:17, 12 February 2013. Reasoned comment invited from editors, especially those who have contributed to the current review of sources and/or revision (Aspheric, FiachraByrne, Harizotoh9, Arc de Ciel, Teapeat, Sbharris, Velella):-

The Criticism section now has two groups: "public bodies" and "personal opinions". The first has only one item, about the National Science Foundation using "alternative medicine" for all treatments that have not been proven effective using scientific methods, previously mentioned more accurately in the Introduction.

The second, "personal opinions", has seven items about "terminology" of which six are the opinions of Wallace Sampson, who is not noted for any particular expertise in terminology (linguistics, grammar, semantics...), nor, so far as can be seen, are his assertions, about misuse or misleading, supported by independent research or evidence, without which his opinions are practically worthless for this article, however correct and sincere they may be. Actually, much of the rest of the criticism ("on scientific grounds and errors of reasoning, taking resources from real medical research, abuse of medical authority, ethics, dangerous misinformation, fraud") is about terminolgy and adverse inferences about motivation, again without visible expertise or support from independent research or evidence: Relman, Novella, Angell, Lundberg(?), Dawkins, Cassileth (letter to US Senate Sub-committee from 'four Nobel Laureates and other prominent scientists'), newspaper staff writer (citing 'a group of scientists'), Stephen Barrett (retired from professional practise in psychiatry), Bausell (?), Butler, Gorski (blog?). Relman is already quoted above in the Introduction, adequately and concisely representing a point of view which is probably so widely held that repetition would amount to protesting too much and be the opposite of convincing, and therefore more likely to benefit the other side of the argument (if there is one).

If those are not omitted en bloc, the section should have opening words such as: 'CAM, and use of the term "alternative medicine", have been criticised, mainly in the USA, on various grounds and for various reasons in the name of consumers, physicians and research scientists in medical journals or elsewhere.'

That leaves: 1_ Kermen and others, Oct 2010. "Family physicians believe the placebo effect is therapeutic but often use real drugs as placebos". Fam Med 2_ Ernst E (September 2003). "Obstacles to research in complementary and alternative medicine", Medical Journal of Australia. Would these be better placed in "Testing" section? Please consider and comment. Qexigator (talk) 17:59, 12 February 2013 (UTC)

Sorry for abandoning this talk page. As a general remark on this section I think the bullet-point format must go and a proper, paragraphed prose style should be adopted. On a practical note I think Sampson, like Colquhoun in the UK, is a significant voice which is not adequately described as personal opinion. Figures such as Sampson represent a perspective from within "mainstream"/"official" medicine/biomedicine that displays a hard-edge towards Alt and CAM therapies and tends to collapse them all into varieties of hucksterism; they tend not to apply the same critique towards scientifically questionable practices from within mainstream medicine (please forgive the terminological inexactness). The influence of this perspective would seem to ebb and flow at various points in time (e.g. impact of Abraham Flexner in excluding alt therapies from US medical schools in the 1910s; also success of Colquhoun's present campaign in UK and Australia). To properly capture this you'd really need a decent, impartial secondary source looking at the dynamic of this discourse between alt/cam and mainstream medicine. The last two chapters in this edited collection touch on some of these issues and might be helpful if carefully used but they are not without their biases and would be inadequate without other sources. I haven't checked, but there must be anthropological and sociological literature that looks at these kind of disputations as forms of boundary making, attempts to capture resources (especially when market share is threatened), the construction of professional identities and ethics, etc. So, if sources can be found, I'd advocate distinguishing between scientific studies of the effectiveness of alt & cam therapies and this inter-professional rivalry where scientific discourse might function as a means to delegitimise/legitimise various positions or proponents. However, absent suitable sources, the above may be irrelevant. FiachraByrne (talk) 00:44, 13 February 2013 (UTC)

The short version is that, in my opinion and if sources offer such a treatment, this kind of discourse should be contextualised as a form of rhetoric that serves many and not necessarily ignoble interests. Questions as to the general scientific effectiveness (or not) of CAM should largely be treated in a separate section with suitable medical/scientific sources.FiachraByrne (talk) 00:52, 13 February 2013 (UTC)

Not quite what I was looking for but here's one:

• • • • Winnick, Terri A. (2005-02-01). "From Quackery to "Complementary" Medicine: The American Medical Profession Confronts Alternative Therapies". Social Problems. 52 (1): 38–61. doi:10.1525/sp.2005.52.1.38. ISSN 0037-7791. JSTOR 10.1525/sp.2005.52.1.38. Retrieved 2013-02-13.

Abstract: This research examines trends in coverage of complementary and alternative medicine (CAM) in five prestigious medical journals during a period of intense reorganization within medicine (1965–1999). Content analysis of a sample of documents (N = 102) shows the medical profession responded to the growth of CAM in three distinct phases. During each phase, changes in the medical marketplace—such as relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the Office of Alternative Medicine—influenced the type of response in the journals. From the late 1960s to the early 1970s, during the condemnation phase, authors ridiculed, exaggerated the risks, and petitioned the state to contain CAM. In the reassessment phase (mid-1970s through early 1990s), increased consumer utilization of CAM prompted concern, and authors pondered whether patient dissatisfaction and shortcomings in conventional care contributed to this trend. Throughout the 1990s, in the integration phase, struggles to outlaw CAM were abandoned, physicians began learning to work around or administer CAM, and the subjugation of CAM to scientific scrutiny became the primary means of control. This analysis demonstrates the evolutionary process of professionalization, a process in which dominance is sustained through adaptation to structural change.

FiachraByrne (talk) 02:03, 13 February 2013 (UTC)

All above (FiachraByrne) noted with thanks. Time will be taken to digest before follow up by.....Qexigator (talk) 08:36, 13 February 2013 (UTC)

--Re-revised Criticism section to prose style without listing format, per above comment. Qexigator (talk) 18:46, 13 February 2013 (UTC)

I've been asked if the use of the term and concept evidence-based medicine in this article is appropriate or helpful. The answer is that I don't think it is, when used as synonym to non-alternative western medicine. it isn't that. Neither this nor AM nor CAM gets a 0% or 100% score--see [72]. Also all good healthcare from physicians or nurses or homeopaths requires comfort, sympathy, empathy, attention. EBM here can only measure effectiveness of these. There are various grades of what is called dismissively "placebo" when you are not after it primarily, but mental health talk or cog behavioral therapy when you are. Since these latter are not alternative, that's loading the dice with semantics. To put it another way, half the science of making people suffer less is based on what we call "comfort and entertainment and caring" when we approve of it, and "placebo use" when we don't.

Lastly there are medical ethics and philosophy questions that EBM cannot address. Some of these are teleological in ways that AM addresses but science can't. And yet they are and must be part of standard non alternative care. Which (again) cannot and is not in fact solely based on science, nor should be even in ideality. SBHarris 08:32, 4 February 2013 (UTC)

That is helpful for guiding editors revising this article, and relevant also in respect of any use of "science-based" as against alternative as these are now better understood. Qexigator (talk) 23:58, 4 February 2013 (UTC)

EBM is a guideline and it differs substantially from Alternative medicine. It's not perfect, nothing is. But it is useful as a contrast to Alternative medicine, such as Homeopathy, which is a clear example of a pseudo-science that isn't even trying to be rigorously scientific. EBM is also mentioned many times by the sources. --Harizotoh9 (talk) 00:32, 5 February 2013 (UTC)

Can you please specify which sources, ideally including quotes. I know it's a hassle but there are already too many statements in the current article that simply bear no relation to the sources they cite. It's easy to fall in to the trap of stating what we think the source should say rather than what it actually does say. Thanks Aspheric (talk) 03:56, 8 February 2013 (UTC)

Asp: please identify to which version you have reverted. [73]. Qexigator (talk) 08:21, 8 February 2013 (UTC)

Reverted to version 536605199 4th Feb, though it's very much shifting deck chairs on the titanic. Pretty much all versions of the article since November and particularly since Jan have been an unreadable mess / angry polemic Aspheric (talk) 21:23, 8 February 2013 (UTC)

Yes, but work in progress has been making some headway, including observations arising from checking of sources and searching for better. Titanic? What about a tramp steamer having a refit in an untidy, undermanned dockyard? Maybe EBM functions as the ship's plimsoll line. Qexigator (talk) 00:01, 9 February 2013 (UTC)

Above [74] I put the link to a section of the EBM article examining use of EBM methodology to alternative medicine (AM), hoping that somebody in this discussion would read that little section. Apparently in vain, since all that has happened is more unthinking use here of the term EBM, as though it were a synonym of natural-science based (i.e. mechanistic philosophy based) medicine, along wih the assumption that these are both antonyms of AM. Sigh. It's not that simple. EBM and the scientific method are epistemological techniques. As such, the provide information about what works.

As such, they find that some AM techniques do work, and (moreover) we cannot simply dismiss such results as "merely placebo effect" because "placebo effect" may be fairly applied in biomedicine to every beneficial interaction between human beings that isn't caused directly by surgery and/or pharmacology. Hence, all priests, clergy, and other such shamans operate by placebo effect. "Sure," you say, "but we don't call them medical." But that's not so, for hospitals have close relations with these people, many of whom believe they cause benefit and whom we manage to avoid calling charlatans.

If you want to press the issue, then psychotherapy and psychology, including hypnotherapy (especially these) operate by placebo effect. But we avoid the term since these people bill ;)). And your taxes pay for their treatments, too. EBM studies would show effects, but would NOT necessarily show that all M.D.s get the full placebo effect, which is complex, multi-functional, and greatly variable in power, for "free" along with whatever molecule or tissue manipulation they happen to be offering. I once read with amusement a well-done clinical study that found that talk therapy was as effective against depression as drugs, but that was on average. Effectiveness varied with the practitioner, and didn't always follow who had the relevant degree. Wups. That's what you find when you apply the methods of science. There exist physicians who project a sort of Marcus Welby effect, whose arthritic patients take up their beds and walk. By contrast there exist others who project a sort of Gregory House effect, whose patients consider shooting themselves, and even think of ways to get in two shots, just to make sure.

In the far future perhaps we will eventually use EBM to separate out the naked effects of molecules from the naked effects of personality. Then we can later combine the effects of both the best of biomedicine with the best of the art of psychology, magic, and showmanship. We would need a name for this ultimate combined practice, which would also have a place for the role of the mind in disease and healing. It would be some kind of *integration* of the two. Hey, it could happen! Just needs a name and some further thought.... SBHarris 05:50, 9 February 2013 (UTC)

Not quite in vain. "It's not that simple. EBM and the scientific method are epistemological techniques." Quite so, understood and agreed. But it is not easy for the layman to follow some of the nuances which may be second nature to EBM practitioners, and here the sometimes unhelpfully hostile editing, particularly some of the less than intelligent jabs at homeopathy. The introductory paragraphs from Bivins, Jutte and Relman, were meant to introduce a tone of reason over polemic. About "placebo": this article on its own cannot describe, let alone unravel, the limitations of placebo, and there is an inclination for the term to be used as a pejorative slogan. Likewise, molecular and particle physics, still continuing mysteries which will remain unresolved by Hadrons and genomes. This article needs to be spared being drawn into such momentous questions, or the tedious clamour associated with wrestling for Federal funds, or perpetuating outdated schoolroom science. Noted that Marcus Welby is liable to be unfavoured for one reason or another. Gregory House? lol--Head of Despotic Medicine. Alas, *integration* still seems to be attracting more badmouthing. Qexigator (talk) 08:38, 9 February 2013 (UTC)

More specifically: The last para. of the EBM Process and progress section [75] has [citation needed]. If a citation were given, which of the three "areas of evidence-based medicine" would be relevant for the Alt.med. article?--

• for individual patients with acute or chronic pathologies, medical practitioners would select treatment options for specific cases based on the best research for each patient they treat.
• systematic review of medical literature to evaluate the best studies on specific topics.
• can be understood as a medical "movement" in which advocates work to popularize the method and usefulness of the practice in the public, patient communities, educational institutions and continuing education of practicing professionals.."

Are there any sources on the extent to which EBM is 1_part of what is typically taught in established medical schools, in USA or elsewhere? 2_Accepted by FDA or similar elsewhere? Qexigator (talk) 11:34, 9 February 2013 (UTC)

EBM is, it seems, an extension of research in a branch of medical science, Epidemiology. The expression 'evidence based' seems to be more relevant to Alt.med. than 'science based', which essentially belongs to another topic and is little better here than a red herring (as mentioned above). But how relevant is EBM-- the use of mathematical estimates of the risk of benefit and harm, derived from high-quality research on population samples, to inform clinical decision-making in the diagnosis, investigation or management of individual patients? If that is a good working description, then EBM can apply to any health-care practice, including the kind now being called 'alternative' or CAM. While that appears to be the purpose of Cochrane, and, for the layman, would have more connection with alt.med. than erroneous reference to 'science based', is it crucial to the alt. med article or no more than a subtopic? It would seem better to leave out 'evidence based' and 'science based', except a concise statement explaining that these terms are sometimes mistakenly thought to be negatively descriptive of alt.med. Is there any credible source which argues otherwise? Such mention as there is in Bivins' account (2007) of the rise of orthodox medicine as currently taught in established medical schools suggests that no favour is done by calling that 'science based' (her account is coolly presented in academic fashion). Perhaps this explains the absence of 'science/scientific' from the index of the BMA publication Complementary Medicine (1993).

In a critique of a particular individual, Relman made some general remarks, without visible support from sources other than his own opinion (based on his own clinical knowledge and as editor of a medical journal of repute). In Some Notes on Andrew Weil- A Trip to Stonesville (1998) he wrote: ''Until now, alternative medicine has generally been rejected by medical scientists and educators, and by most practicing physicians. The ... most important reason is the difference in mentality between the alternative practitioners and the medical establishment. The leaders of the establishment believe in the scientific method, and in the rule of evidence, and in the laws of physics, chemistry, and biology upon which the modern view of nature is based. Alternative practitioners either do not seem to care about science or explicitly reject its premises. ... they do not appear to recognize the need for objective evidence, asserting that the intuitions and the personal beliefs of patients and healers are all that is needed to validate their methods. But, in my view, Relman's article is worth quoting, as in the current version of the Alt. med. article. Qexigator (talk) 15:43, 9 February 2013 (UTC)

Omitting EBM from CAM is not possible where the literature exists. The article needs more EBM not less of it. DVMt (talk) 22:03, 18 February 2013 (UTC)

This statement "CAM used together with conventional medical treatment, in a belief, not proven by using scientific methods, that it increases the effectiveness, or "complements", the treatment." is severely biased and NPOV. The words 'belief' and 'not proven by scientific methods' are weasel words. Also, the sources include an American white house statement in 2002 and a 1995 primary source from Edzard Ernst no less (severe bias). Secondary and tertiary sources are preferred as per WP:MEDRS. Why not use the WHO tradtional medicine/CAM document? It supersedes any national health care organizations and is a reliable, credible and distinguished body. DVMt (talk) 20:01, 16 February 2013 (UTC)

Noting your remarks about 'in a belief, not proven by using scientific methods', and about 'American white house statement in 2002 and a 1995 primary source from Edzard Ernst', given that this lead's wording is a sensitive area for some editors, perhaps you would show here (before making the revision) what rewording you propose, including sources? Is WHO descriptive or prescriptive? What authority does it have over regulatory bodies (such as medical schools or FDA or licensing bodies) of countries and states? Qexigator (talk) 21:45, 16 February 2013 (UTC)

--Also, is there anything to support the remark of "severe bias" on the part of Ernst, implying greater bias than other proponents or opponents? Irrespective of sincerity and personal conviction, there is hardly any source that is not making a living out of what s/he writes on the topic, as researcher, journalist for a commercially owned publication (with target readership, and advertising), educator, practitioner, or, in the case of public bodies, operating to a prescribed mandate or objective? Qexigator (talk) 19:08, 17 February 2013 (UTC)

I am still waddling through all the material you asked me to review. Objective scientists can definitely see that Ernst is an outlier and therefore we must be careful to too puch too much weight on his views, or give the diametrically opposing view equal weight and text. It can be tricky. The WHO is descriptive in nature I believe, but I would have to review it carefully for more details. All national medications associations (i.e. AMA, CMA, BMA, etc...) are part of the WHO which is a conglomeration of all national bodies in all the licensed professions. As such, I believe that their view trumps national views. DVMt (talk) 19:51, 17 February 2013 (UTC)

"waddle" - lol! as in "quacking ducks"? Even a layman may have doubts about Ernst, and in another encyclopaedia he might get short shrift, but sometimes Wikip. editors insist on giving more weight than others would. Look forward to the results of your review, and comments others may have, and meantime maintaining the npov stance of one who is reasonably sceptical of all claims and assertions on all sides. Qexigator (talk) 21:19, 17 February 2013 (UTC)

I'm glad you picked up on my 'waddle' pun! Given that the Ernst article is from 1995, it would be nice if he wrote something more current, or have a secondary source. Regarding NPOV, I'm sure we all have the best intentions here but a minefield like 'CAM' needs to be very precise and concise with language and sources, moreso in the fact we must respect cultural relativity. DVMt (talk) 22:27, 17 February 2013 (UTC)

Not sure how useful cultural relativity is for npov description of this topic, if the alt. in CAM is traceable (broadly speaking) to unorthodox per Flexner. That is a complex enough phenomenon for a study specifically of the development of medical practice, healthcare and medical insurance in USA (+ sidelong look at Canada), sometimes in bitter opposition to homeopathy (previously imported from Germany/Britain), and later developments such as naturopathy and chiropractic, and Christian Science, and more recently, acupuncture etc. But it is not the topic of the article. In my view, CAM, as a precise or loose term of art used in connection with regulating food, drugs and therapies, funding research, and in the diffusion of knowledge mainly by activities such as Cochrane Collaboration, can be seen to have had a point of origin in time and place, and some diffusion over time within and beyond the borders of USA and other countries. I see no place for cultural relativity, if we are describing what is found from time to time in this or that country by name. If WHO fails to recognise that, it may be less than helpful here. On the whole, the article now seems to cover most of the relevant points, if in an uneven style, and allowing for differences among editors about what to expand and what to cut, partly due to the shifts and changes actually happening in the real world, not least in the developing concepts affecting experimental scientific research, such as the so called "placebo" tests, and concerns of Relman and others about the operations of pharmaceutical companies. WHO has six "core functions"[76], the more relevant of which could be: shaping the research agenda and stimulating ... dissemination of valuable knowledge; setting norms and standards and promoting and monitoring their implementation; articulating ethical and evidence-based policy options. But how is that related to healthcare in North America, Australia, Europe, Africa, India, Asia? Is there any source which shows that it has influenced a change in public policy, medical teaching, pharmocopeia, licensing for medical practice as a physician or otherwise? If so, how can that be mentioned succinctly in the article, say a sentence or two? Qexigator (talk) 23:46, 17 February 2013 (UTC)

For some mention of WHO now see revision 15:52, 18 February 2013 (moved Cochrane Scope up from "Institutions")[77] --Qexigator (talk) 16:01, 18 February 2013 (UTC)

I'll check into this. Agreed re: cultural relativism. You're going to have to clarify your post; your main points were lost. We need to address my primary concerns a) weasel words b) outdated sourcing and c) why the WHO, NCCAM or other reliable agencies have no mention in the lead. DVMt (talk) 18:36, 18 February 2013 (UTC)

The lead reads:

Alternative medicine is any of a wide range of health care practices, products and therapies, which typically are not included in the degree courses of established medical schools. Examples include homeopathy, Ayurveda, chiropractic and acupuncture.

So then, these subjects are not taught in medical schools in China, India, Japan, etc.? Gandydancer (talk) 19:02, 18 February 2013 (UTC)

This is a great point. Also there are no sources for the opening sentence of the lead which is essential, IMO. Clearly acupuncture is taught in Chinese medical schools, the TCM version I'm sure. I don't think that TCM is China is 'alternative'. DVMt (talk) 19:26, 18 February 2013 (UTC)

--1_DVMt: Sorry, don't know what 'main points were lost'. Looking again, the above seems to say what was meant. Let's not dwell on that but look at your 'primary concerns', a) weasel, b) sourcing, c) WHO and NCCAM not in lead. a) what words are 'weasel'? b) what do you propose for update? c) WHO see above: WHO has six "core functions", the more relevant of which could be: shaping the research agenda and stimulating ... dissemination of valuable knowledge; setting norms and standards and promoting and monitoring their implementation; articulating ethical and evidence-based policy options. But how is that related to healthcare in North America, Australia, Europe, Africa, India, Asia? Is there any source which shows that it has influenced a change in public policy, medical teaching, pharmocopeia, licensing for medical practice as a physician or otherwise? If so, how can that be mentioned succinctly in the article, say a sentence or two? If not it is marginal to this article, and in my view deserves no more than inclusion in External links, at most, given that TM and NCCAM have their own articles, linked by the side panel (per Update: WHO? in top section of this page). For NCCAM, what do you propose?

--2_Gandy: agreed this needs clarifying. Is there a source to show what they teach? Could we add at the end of the first sentence "teaching western medicine in the tradition of the Flexner Report or similar" to read: "Alternative medicine is any of a wide range of health care practices, products and therapies, which typically are not included in the degree courses of established medical schools teaching western medicine in the tradition of the Flexner Report or similar.", but that may be opposed as SYN or OR (I don't which is deemed the worse of these offences)? Qexigator (talk) 19:42, 18 February 2013 (UTC)

Flexnor report is an old an American-centric reformation of US medical schools circa 1900s. It is irrelevant here. Why not use an international definition of CAM like here [78]. Unless you find the WHO isn't a reliable and credible organization. DVMt (talk) 20:01, 18 February 2013 (UTC)

Qexigator, I have no intention of getting into your discussion here because I learned long ago that this article has been and will continue to be biased no matter what I do. For years the definition in the article was supplied by a Missouri folklorist with a degree in English. No amount of complaining on my part did any good at all. Then one day an admin dropped by and deleted it (that was NW) and it has been gone ever since. Having watched this article for a long time, what I've seen is that editors that are perfectly good and mindful of WP guidelines in other articles just throw all that to the wind when it comes to this article. There seems to be a need to right great wrongs that is so strong that every sort of reason imaginable is thought up to avoid using an "official" (such as Cochrane, etc.) definition in the lead because they tend to not draw such harsh lines between the different forms of medicine. There actually is "real" medicine that does not work, you know that, right? Or "real" medicine that is eventually judged to be so dangerous that it can no longer be advised? And there is alt med that does work, though it may as yet lack in good studies that say so. And so on. There is no hard line between the two, even though it would seem that this article is hell-bent on drawing one. OK, off the soapbox. Here is a link to sample some Chinese med school classes: [79] Gandydancer (talk) 21:43, 18 February 2013 (UTC)

Agreed. There is no line, it's a continuum. That's why this article and other CAM articles are in such disrepute. DVMt (talk) 21:58, 18 February 2013 (UTC)

Gandy, thanks for all that. Sure, there is "real" medicine that doesn't work. At present here in UK there is an ongoing scandal about maltreatment in NHS hospitals, with thousands of deaths attributed (mainly due to neglect of proper nursing and hygiene under the eyes of regular consultant physicians and surgeons, but they love to holler - in the name of "science" - against the homeopaths who at least offer proper care and nursing). The Flexner Report about N.American medic. education (mentioned below) is a key part of the process which resulted in determining what today is "fringe"" to that orthodoxy, in the way Jutte described. Quite a few would prefer not to know. Will now go and peruse the Chinese link. Cheers again! Qexigator (talk) 10:40, 19 February 2013 (UTC)

BR opposes a move to complementary/alternative medicine. Given that the NCCAM, WHO and Cochrane all refer to it as CAM, why is their objection for there use in the article and the title of the article itself? DVMt (talk) 04:05, 19 February 2013 (UTC)

Although I have some other objections, right now I'm objecting to your failure to follow proper procedure. We edit collaboratively here, and such a name change is very controversial. You shouldn't make such a move unilaterally. Follow the proper process. Start a properly named thread and discuss it. If a consensus cannot be reached, then create an RfC and a new discussion. Only make the change after a clear consensus has been reached. -- Brangifer (talk) 04:46, 19 February 2013 (UTC)

The process is agreed upon. What about addressing my concerns above regarding the Cochrane, NCCAM and the WHO? DVMt (talk) 04:52, 19 February 2013 (UTC)

BTW, have you really considered what CAM (Complementary and alternative medicine) means? It's an umbrella term that is not synonymous with "alternative medicine." It needs no more than a few words to explain that fact, and we've done that in this article. It also redirects to this article, so don't play around with titles or redirects, because then bots go and screw things up even more. It makes for lots of work to restore order to things. -- Brangifer (talk) 04:57, 19 February 2013 (UTC)

Those are all good sources which we use. If we're missing something, then please propose the phrasing and references you'd like to use. Please do it here so we can get a consensus and avoid disturbing/destabilizing the article. This happens to be a very sensitive and volatile article. It's been stable for some time, but now we're in danger of serious problems. It would be a shame if the article were locked down if edit warring occurred. -- Brangifer (talk) 05:01, 19 February 2013 (UTC)

I understand fully what it means. You have not addressed my main points above, again. Are you opposed to using mainstream health organizations WHO, NCCAM and Cochrane in the lead? Are you opposed to editing this per WP:MEDRS? Perhaps the volatility is due to their lack of inclusion. DVMt (talk) 05:05, 19 February 2013 (UTC)

I have no objection to using those sources, if relevant and unique, in the body, and then possibly in the lead. Propose such content and let's look at it. "Editing this per MEDRS"? Any direct biomedical claims are governed by MEDRS, while controversy is not. Specific articles about each alternative medical topic (such as homeopathy and acupuncture) should already be following MEDRS. Is there anything specific "here" you are referring to? -- Brangifer (talk) 05:11, 19 February 2013 (UTC)

Concur with Brangifier. There is certainly room for continuing improvement in the article (sources etc. as above on this page), but whether that will result in a reasonable proposition for name change remains to be seen, after revisions in that direction have been done. At this stage, the present name should stay. Is anyone aiming at "Philosophy of ...."[80] ? Qexigator (talk) 11:00, 19 February 2013 (UTC)

In the first sentence a reference has been added to the Flexner model and western medicine in established medical schools in China, and in India. Editors may wish to add something in the body, properly sourced (WHO?), to clarify the use of the term "alternative" there or elsewhere. Qexigator (talk) 18:11, 19 February 2013 (UTC), Qexigator (talk) 19:19, 19 February 2013 (UTC)

The word "conventional" is used about 200 times in this article, without the context provided in the sources. This is massively undue weight. If the word must be massively repeated for some purpose, it will be replaced with the context provided in the sources, - "convetional" to "conventional, science based" - so the reader is not misled by an ambiguity in "conventional", when there is no ambiguity in the sources; in the cited sources, "conventional medicine" is to "science based medicine". There is no reason to create an ambiguity where none exists.

Is this any more than pedantry? "conventional" is used 1_in at least two of the sources cited in the lead as at 23:34, 19 February 2013[81] 2_in two subtopics in section "Safety". 3_In Introduction, twice with reference to Cochrane Collaboration, once with ref. to Ernst, and again in ref. to NCCAM. 3_In the heading "Interactions with conventional pharmaceuticals" ... and so on as would be expected in such an article. In the citations there are at least 6 "conventional" and 5 "unconventional/nonconventional". It is being used as a matter of convenience in the usual and conventional way meaning: following generally accepted principles, methods and behaviour (per Wiktionary). Qexigator (talk) 09:45, 20 February 2013 (UTC)

(For Qexigator} According to the OED the first use in English was:

• Kruger, H. (1974). Other healers, other cures: a guide to alternative medicine. Bobbs-Merrill. ISBN 9780672517082.

Cite OED as:

• "alternative, adj. and n.". Oxford English Dictionary (OED Online ed.). Oxford University Press. December 2012. Retrieved 20 February 2013. (subscription required)

It didn't have a separate entry in the 1989 edition of the OED and first instance cited was:

• "1983 Brit. Med. Jrnl. 30 July 307/1 One of the few growth industries in contemporary Britain is alternative medicine.

FiachraByrne (talk) 18:52, 20 February 2013 (UTC)

Thanks. Done, please tweak if needed. Qexigator (talk) 19:37, 20 February 2013 (UTC)

Not an ideal source, but this is also useful: [82] FiachraByrne (talk) 19:50, 20 February 2013 (UTC)

The linked page is good confirmation but maybe not easy to work into the text and cite. One problem is it uses "CAM" in a way that could be mistaken for implying there was a definite entity by that name at that time. Also goes into historical complexities of 18c. -- interesting but too far off this article's topic. Noted that the book is Complementary and Alternative Medicine, Insights and Perspectives from Leading Practitioners ed. Norma G. Cuellar of University of Pennsylvania, Jones and Bartlett Publishers Inc., Sudbury MA, Mississauga Ontario and London UK, 2006.(£22.33 + £2.80UK, Amazon). It is presumably CAM pov. Good to see the Intro. citations have been tidied up. (Gandy's red for Jutte had prompted me to give link for him in the citation.) Qexigator (talk) 21:01, 20 February 2013 (UTC)

Text is anachronistic, I think. Useful, however, in detailing terminological changes: "irregulars" -> "medical sects" -> "alternative medicine". This article is in severe need of a formatting and copy edit. One way to drop a bomb might be to send it to peer review (although editors might calculate that article is unlikely to remain stable and therefore edits might be a waste of time). FiachraByrne (talk) 21:08, 20 February 2013 (UTC)

That that text is CAM POV is neither here nor there for the matter at hand - it's not ideal because it's an interview not because of the perspective as the remarks are pretty much purely factual and, as it happens, factually correct (historical terms for what we now call alt med; when did the term alternative medicine rise to prominence). FiachraByrne (talk) 21:11, 20 February 2013 (UTC)

Yes, noted p.5 first of all then read around. Why would copyedit and formatting need peer review? Actually, bombthrowing of that kind is outside the competence of my auto-remit. But if others see that the time is ripe, let right be done. Qexigator (talk) 21:19, 20 February 2013 (UTC)

Well you shouldn't read around you know, you might come across all kinds of crap ;). The purpose was just for a (an imperfect) cite in support of the statement that the term came to prominence in 1970s; nothing else. It may or may not be relevant to look at terms to describe alt med in other countries (Europe really). Ramsey's article does that Ramsey, M. (1999). "Alternative medicine in modern France". Medical history. 43 (3): 286–322. doi:10.1017/s0025727300065376. PMC 1044147. PMID 10885126.. I'll look for a better source but my own resources mostly cover 19th century. Peer review is a pretty flippant suggestion but it's just a means of getting input and suggestions on article improvement from an editor (hopefully) not invested in either POV or emotionally invested in the article due to the time they may have devoted to it. I'm not sure, however, that an experienced peer reviewer, say someone like Ruhrfisch, would be willing to take it on. FiachraByrne (talk) 21:45, 20 February 2013 (UTC)

What reads around comes around. Understood your intent about imperfect and all that. The important thing is to keep the article focused which is the aim of all my edits. Now for another look at Ramsey. I may be some time. Qexigator (talk) 21:54, 20 February 2013 (UTC)

--After looking again at Ramsey,[83] I see much that is interesting, and perhaps relevant to History, but nothing pertinent to Alt.med. article other than as at Alternative Medical Systems[84] There is a certain amount of detailed information about the regulation of medical practice peculiar to France. It has one possibly quotable sentence (p.319) "There seems little prospect in the near future for a major liberalization of the French regulatory regime that keeps alternative practitioners in the status of medical outsiders." Qexigator (talk) 02:01, 21 February 2013 (UTC)

Relevant content relates to terms for alt med in France and Germany. Is all. FiachraByrne (talk) 02:28, 21 February 2013 (UTC)

1970s FiachraByrne (talk) 02:37, 21 February 2013 (UTC)

Parallel (acrimonious) professionalisation; mirrors "official" med; alt med is changed by this process; becomes like ...

Thanks again for those two, good finds. All grist, but for what mill (Gristmill)? On this occasion I have left reading around aside (that may happen later). Interesting to see Saks's account (2003) of BMA moving from opposing "alternative" outright to prudential acceptance of "complementary". In my view, History of alt.m. (enviably well-ordered article) would benefit from a section based on that narrative, and: "...the pattern of medical absorption of alternative therapies generally appears to have gone further and faster in the United States..." Of course, that is only a part of the whole which has to do with much else including public health and hygiene, work and leisure activities, aches - pains - stress - intoxicants - homelife and habits, and so on. Ditto The Handbook of Social Studies in Health and Medicine (2000). The fact is, this topic's main notability is its inherent or natal connection with medicwars down the ages, compounded with sciencewars, philosophwars and culturewars, which seem to be part of a never-ending epic, and the least opinionated Wp editors may find themselves In medias res, like poets, novelists or war correspondents. If it came to blamestorming, one could try a dose or two of epistemology, possibly in potentized dilution. Cheers! Qexigator (talk) 09:38, 21 February 2013 (UTC)

(edit conflict) Prior to getting back to the History of alternative medicine article (currently stalled at el magneto; still have to add content on ether vs magnetism), I have to finish Lobotomy (just starting section on Walter Freeman and the "ice-pick of oblivion", etc; drawn back there due to complaints that the article wasn't sufficiently condemnatory) and I also have to finish Bethlem Royal Hospital (currently stalled at section on the unfortunate James/William Norris). Thankfully, I've been given an exit out of an intemperate and ill-judged commitment to rewrite the intolerably fucked up article on Medical history which would have been a bit of a behemoth under ideal circumstances (and the circumstances are far from ideal). I have a problem with finishing articles evidently (there are others I've been meaning to "edit", fragments in my sandbox, but anyway). If you like, after I finish lobotomy, I could prioritise the 1970s section in the History of alternative medicine.

Not unusually for wikipedia, the very conflict which should be the object of analysis has been imported into the actual writing process. Interesting in itself, but not conducive to the production of encyclopaedic content. Collateral damage has always been a feature of asymmetrical warfare. The rhetoric of denigration doesn't entertain any dilutions, not least by "philosophy", "epistemology", or other quasi-fringe objects. FiachraByrne (talk) 10:20, 21 February 2013 (UTC)

--added to public discussion ref, please tweak if needed. Qexigator (talk) 10:09, 21 February 2013 (UTC)

If you paste a Google Books url into this little browser tool it will automatically generate a templated wikipedia citation.FiachraByrne (talk) 10:30, 21 February 2013 (UTC)

--el magnifico et aussi la guerre (duke in wellies, inspecting quackpond?). My neutral pov is, the other topics deserve completion (allowing, sadly, for stepping out of Medical history for reason given). My personal preference is: please complete History of alternative medicine, as an urgently needed adjunct to the "main" article. And now another wotsit has been supplied! - must give it a try. Qexigator (talk) 10:39, 21 February 2013 (UTC)