Talk:Homeopathy/Archive 15: Difference between revisions
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::::I need to also say that Howard's assertion that homeopaths do not believe in "etiology" is just one more unfounded assumption he has made (no big surprise). Homeopaths simply have a more sophisticated viewpoint on etiology than Howard and reductionistic scientists do. For infectious disease, for example, we believe in germs, but we also believe in host resistence. While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence. I am beginning to think that Howard is simply unable to understand homeopathy. Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time. I look forward to Howard's contributions if he can show real intellectual effort here rather than creating straw men and creating arguments/fights when none exist. [[User:Dana Ullman|Dana Ullman]] 03:00, 22 September 2010 (UTC) | ::::I need to also say that Howard's assertion that homeopaths do not believe in "etiology" is just one more unfounded assumption he has made (no big surprise). Homeopaths simply have a more sophisticated viewpoint on etiology than Howard and reductionistic scientists do. For infectious disease, for example, we believe in germs, but we also believe in host resistence. While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence. I am beginning to think that Howard is simply unable to understand homeopathy. Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time. I look forward to Howard's contributions if he can show real intellectual effort here rather than creating straw men and creating arguments/fights when none exist. [[User:Dana Ullman|Dana Ullman]] 03:00, 22 September 2010 (UTC) | ||
===Strawment Produce text, not attacks=== | |||
Cannon, I would note, is a 1963 book, which appears to be aimed at a lay audience. Of course, rather than the sarcastic "I could quote", a far more constructive approach would be to do so. | |||
Please stop yelling about strawmen and propose text. Please stop making sweeping inferences such as the theory of evolution proving the wisdom of the body, which you have yet to define rigorously. "Even MDs" is meaningless without citation, and citation of current and authoritative ones. As I mentioned, it simply does not appear in the indexes major textbooks: ''Harrison's Principles of Internal Medicine'', the Hopkins ''Principles and Practices of Medicine'', ''Best and Taylor's Physiological Basis of Medical Practice'', or the Guyton-Hall ''Textbook of Medical Physiology.'' My copy of Cecil's Internal Medicine does not come immediately to hand. If it is such an accepted, well-defined concept, one might think that some of the most widely used medical school textbooks might mention it, might one? | |||
'''PROFESSIONALISM ALERT for <nowiki>{{nocomplaints}}</nowiki>''' <blockquote> I am beginning to think that Howard is simply unable to understand homeopathy. Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time. </blockquote> | |||
"While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence [sic]." Nonsense. [[B-lymphocyte]] and [[T-lymphocyte]] immune response are clearly host defenses, although, in some cases, [[immunoglobulin]]s may be provided externally. [[Interleukin]]s and other [[cytokines]] are signaling mechanisms for host defenses. [[Granulocyte-macrophage colony-stimulating factor]] deals with improving cellular responses. | |||
[[Tumor necrosis factor-alpha]] is a host defense that frequently becomes hyperactive and needs to be returned to safe levels; the area of overactive host defenses is an important one, as in [[anemia of chronic disease]] with the fairly recently recognized roles of [[hepcidin]] and interleukin-6, or, overwhelmingly, in [[autoimmune disease]]. In other words, sometimes the body is about as wise as a teenager being challenged by peers after non-homeopathic dosages of a remedy with the (vivid) memory of ethanol. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:53, 22 September 2010 (UTC) | |||
== Rationalwiki == | == Rationalwiki == | ||
I hope one of you can write an article on the retionalwiki refuting their allegations about CZ as well as the CZ article on homeopathy.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:43, 20 September 2010 (UTC) | I hope one of you can write an article on the retionalwiki refuting their allegations about CZ as well as the CZ article on homeopathy.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:43, 20 September 2010 (UTC) |
Revision as of 21:54, 21 September 2010
The talk page has been moved to Talk:Homeopathy/Archive 13 because of its size.
If you want to continue some topic please copy the relevant excerpts to this new page.
Sandy's edit to the definition
...specifically "help to cure or prevent illnesses involving similar symptoms." While a homeopath will have to review this, I don't think "illnesses involving similar symptoms" is really a homeopathic concept. They certainly object to "diseases with similar symptoms", and tend to reject "disease" as a medical conceit. The symptoms are signals of the body's defenses to be strengthened, not the effects of a causative factor. Howard C. Berkowitz 04:59, 18 September 2010 (UTC)
- I think you're splitting hairs, but, yes, let's hear from a homeopath on this. D. Matt Innis 21:27, 18 September 2010 (UTC)
- Sandy's new definition is definitely an improvement. D. Matt Innis 21:32, 18 September 2010 (UTC)
- Li'l hard pressed for time. I'm happy with Alexander's definition, but if you guys feel it needs to be simpler, I have a 'simpler definition', which would read:-
(Homeopathy is) an alternative system of medicine, which stimulates the natural healing processes of the body (with the help of sub-physiological doses of a remedy, by using its rebound effect), to restore health (homeostasis) in a sick person.
- The matter in brackets is optional.—Ramanand Jhingade 07:36, 19 September 2010 (UTC)
- Note that it is alternative medicine and not alternate medicine.—Ramanand Jhingade 07:44, 19 September 2010 (UTC)
- Li'l hard pressed for time. I'm happy with Alexander's definition, but if you guys feel it needs to be simpler, I have a 'simpler definition', which would read:-
- Unfortunately, "rebound effect" is not a well-defined term, certainly in medicine, so should not be used in a definition unless it is well defined in an article of its own. The alternate definition depends heavily on homeopathic terminology, such as "natural healing processes", as well as using homeostasis is far broader a context than is used in the biological sciences -- to say nothing amout emerging concepts such as allostasis.
- The proposed new definition also overemphasizes the aspect of small doses and does not address the apparent rejection, by homeopathy, of the idea of "disease". Instead, it speaks of "restoring health", without addressing the meaning of the state of non-health.
- Please confirm or correct the statement that homeopaths do not believe in the concept of disease, in the sense that disease has an etiologic cause and the cause needs to be corrected. Howard C. Berkowitz 08:30, 19 September 2010 (UTC)
- I agree with Howard here, Ramanand, that your version introduces too many vague terms to be considered for use as a one sentence definition. D. Matt Innis 23:44, 19 September 2010 (UTC)
What about
A system of alternative medicine based on the idea of stimulating the body's natural healing processes by administering tiny doses of substances which, when given in large doses to healthy individuals, cause similar combinations of symptoms.
I agree that Ramanand's definition has some problems, and I think the full version is too long, but it seems to me the point about stimulating natural defenses is central. Sandy Harris 03:07, 20 September 2010 (UTC)
- Looks good. I have no problem with replacing your previous version with this new version. D. Matt Innis 17:27, 20 September 2010 (UTC)
- Friends...first, I understand the need to archive material, but I wish that one would have not archived the most recent material. There was still some important discussion to complete there. Can I encourage someone to consider re-inserting some of it?
- I agree with others' concerns about Ramanand's proposal, and I like Matt's proposal, though here's my slight tweak on it (the words in italics are my new ones):
A system of alternative medicine based on the idea of stimulating the body's natural healing processes by administering tiny specially prepared doses of substances which, when given in large doses to healthy individuals, cause a similar syndrome of symptoms.
Dana Ullman 08:40, 21 September 2010 (UTC)
The above comments have been copied from the Archive. --Peter Schmitt 10:28, 20 September 2010 (UTC)
Natural defenses
There is an implicit homeopathic assumption here here that natural defenses are always sufficient, that restoring natural defenses equates to health. From a medical standpoint, that is sufficiently wrong that "natural defenses", or the idea that full health is a matter of restoring defenses, is rather basic. Consider, for example, genetic diseases such as cystic fibrosis or hemophilia. The problem, from a medical standpoint, is that the "natural" state is incomplete for health. With genes missing to produce the proteins that produce health in a "normal" person, all the "strengthening" in the world will not strengthen something that isn't there. In severe combined immune deficiency disorder, the most pronmising research to externally insert the gene that encodes the manufacture of the key missing enzyme, adenosine deaminase.
In other words, sometimes the wisdom of the body is pretty damn stupid, and all the strengthening in the world can't replace something that isn't there. It doesn't help explain etiology when etiology can be due to an absent rather than a present cause -- but how else do you talk about sensibly about deficiency and genetic diseases? The evidence that scurvy comes from inadequate vitamin C is overwhelming.
Proposal:
"Homeopathy is a form of alternative medicine that holds that good health is achieved purely by strengthening what homeopaths, but not conventional medicine, calls "wisdom of the body" or "natural defenses". Homeopaths further believe that all problems of natural defenses manifest themselves as symptom complexes, and reject the idea that disease has a cause and health is restored by the removal of the cause. They hold that the symptoms show the defenses that need to be strengthened, and their remedies are based on a symptom, not cause, oriented paradigm. Howard C. Berkowitz 11:05, 20 September 2010 (UTC)
- The definition is supposed to briefly say what homeopathy is. It needs to be short enough to fit into a related articles page. To me, your suggestion fails at those goals; either the current text or my suggestion above seems far better.
- There needs to be discussion of these issues somewhere in the article, perhaps even in the lede, but it does not belong in the definition. Sandy Harris 12:17, 20 September 2010 (UTC)
- I'm fine with both of Sandy's definitions. I hope one of you can make time to correct the definition at the top of this page - it should be alternative and not alternate.—Ramanand Jhingade 15:21, 20 September 2010 (UTC)
- Absolute minimum: Homeopathy is a form of alternative medicine that holds that good health is achieved purely by strengthening what homeopaths, but not conventional medicine, calls "wisdom of the body" or "natural defenses", rejecting the medical model that the etiologic cause must be corrected.
- The method by which remedies are selected (i.e., provings) and prepared are irrelevant to the core definition. According to Mr. Ullman, not every homeopathic remedy is given in "homeopathic doses", so let's not overemphasize the small dose issue. Howard C. Berkowitz 16:32, 20 September 2010 (UTC)
(unindent)
I suggest something like:
- "A system of alternative medicine, developed around 1800 by Samuel Hahnemann, based on the assumption that self-healing can be stimulated by small doses of substances that cause the same symptoms as those to be treated."
--Peter Schmitt 21:58, 20 September 2010 (UTC)
- I am very concerned about Howard's "implicit assumptions" about homeopathy because he is simply wrong about them. Homeopaths do NOT believe that the body's natural defenses are always sufficient for restoring health. To be candid, this is a totally ridicious assumption, and after ALL of this time in which Howard has been editing this article, I am surprised that he would believe such a ridicious assumption. I urge all editors to avoid guessing at what homeopaths think or do. Please consider ASKING before assuming or at least making reference to a specific established expert who made a specific statement. Our encyclopedia here deserves better scholarship than something based on assumptions, let alone "implicit assumptions." When an editor here has some deep antagonism to homeopathy, it is particularly important to avoid making assumptions without specific and references FACTS because such assumptions tend to create "straw men" (a problem about which I have frequently expressed concern in the past).
- IF the natural defenses were always sufficient, there would not be any need for healing treatments. That said, homeopaths do believe that our symptoms represent the best defensive efforts that the bodymind can deploy at that time based on its present internal resources. However, such efforts are often not enough, and therefore, medicinal and/or therapeutic efforts are necessary. Homeopaths believe that those efforts that mimic and augment these natural defenses will be the most effective, while methods that suppress, inhibit, or work by counteracting the body's symptoms may provide "benefit" briefly but will tend to create more serious physical and psychological symptoms and syndromes in the longer term (homeopaths refer to this phenonmenon as "suppression of disease," while conventional physicians simply refer to them as "side effects").
- Howard is also inaccurate about his understanding above about "homeopathic provings." Howard wrote: "The method by which remedies are selected (i.e., provings)" -- To clarify, "provings" are experiments in toxicology that verify the specific symptoms and syndromes that each substance CAUSES in overdose. After a homeopath interviews a patient, the homeopath looks to find a substance that has been found to cause in healthy people the similar syndrome of symptoms that the sick person is presently experiencing.
- I urge Howard to prove and verify that a homeopath and an allopath would have different definitions of "the wisdom of the body." I personally do not know of any such difference. Yes, I do have a deep antipathy to homeopathy, but it's rather hard to come up with citations for negative information. Harrison's and Cecil's, as a start, don't use the term.
- BTW, Peter's defintiion above is inaccurate. Homeopaths do not use substances "that cause the SAME symptoms..." but instead "that cause SIMILAR symptoms." Get it? Homeopathy IS based on the principle of SIMILARS. That said, there ARE some applications in homeopathy that "treat SAMES with SAMES" (as in the 4 studies by Reilly and his team at the University of Glasgow in their treatment of people with various allergic ailments, where they used potentized doses of specific ALLERGENS to which people were most reactive. Dana Ullman 09:08, 21 September 2010 (UTC)
- Thank you, Dana, because you are now being more specific and more limiting about some things that either have been said previously by you, or by Ramanand.
- I have never said that an allopath has any assumptions about the wisdom of the body, because I don't know any allopaths. If, by "allopath", conventional physician is meant, the proof is easy: "wisdom of the body" is simply not a medical concept. I don't see it in the index of any of my major textbooks of internal medicine. Ignoring the continued insistence on allopath, the difference on wisdom of the body is binary: one discipline believes in it and one does not. You asked an apparently rhetorical question about belief in wisdom of the body, which I answered that I, and most medical scientists, do not believe there is such a thing.
- Whether or not there is a historic use of allopathy, in the United States, people are licensed as physicians (nurse practitioners, physician assistants, etc.), not allopaths. Homeopaths, where licensing applies are, as far as I know, licensed as homeopaths. I can ask him to see if there's a difference, but my best DO friend's licenses to practice in Missouri and Louisiana are for the practice of medicine, not allopathic or osteopathic medicine.
- "However, such efforts are often not enough, and therefore, medicinal and/or therapeutic efforts are necessary. " Agreed, but please be specific. The existing alternate rather than complementary emphasis of the article has made quite a point of saying homeopathy comes first. A short list of examples where a homeopath would call for an ambulance would be very informative.
- Correction. Remedies are not selected by provings, but are they not the means to find a simillium?
- It's now on the archive page, Dana, but I thought you said homeopathic remedies were not always given in homeopathic dosages. If I remember that correctly, then the "wisdom of the body" and strengthening defenses, perhaps with a few words about the difference with medicine, is more central to the definition than the aspect of small and specially prepared doses. Both belong early in the introduction. Howard C. Berkowitz 10:40, 21 September 2010 (UTC)
Howard, thanx for clarifying some issues. You have suggested above that conventional physicians really do not have a specific meaning for or appreciation of "the wisdom of the body." To me, that alone says volumes...and I agree with that. In fact, it seems that the average physician has distrust of the ability of the human body to defend and repair itself, thereby requiring intervention that usually (though certainly not always) works counter to the body's present symptoms.
As for the use of the word "allopathy" and "allopathic," you may be very surprised and even shocked how many conventional medical schools, licensing boards, institutions, US governmental agencies, and accrediting agencies still utilize this word. I highly recommend that you see the "huge body of references" compiled by Brian Hopping at: http://en.wikipedia.org/wiki/Talk:Allopathic_medicine
To clarify on the licensing of homeopaths, there are only 3 states in the USA that license MDs who practice homeopathy (CT, AZ, and NV). Licensing in homeopathy is NOT necessary to practice homeopathy. FYI, these 3 states licensed MD/homeopaths because some MDs who practiced homeopathy were being harrassed by conventional MDs, so they set up their own licensing board. Most MD/homeopaths are NOT being harrassed by other MDs, so it is not necessary to set-up their own boards.
In addition to MDs who practice homeopathy, virtually every type of health/medical professions have some people who practice homeopathy, PLUS there are "professional homeopaths" (individuals who specialize in homeopathy and who are not licensed in any other health/medical profession).
As for when a homeopath would call an ambulance...it would be the same protocols for which conventional MDs would call an ambulance. Is that clear enough? Dana Ullman 17:11, 21 September 2010 (UTC)
- OK, please take the following on ...well, good "faith" is singularly inappropriate, for a reason I think you'll soon see. I'm not exactly suggesting there is a consensus, but I would hope that it might be possible for the different sides to have their incompatibilities, and indeed fears, clearly stated.
- I could get along with "wisdom of the body" in the context of religion or transpersonal psychology, but not medicine. By "medicine", I use Marcia Angell's definition: there are two kinds of medicine. Medicine that works and medicine that doesn't work. Yes, adults have a right to faith healing -- but courts have held they do not have a right to do so for children. It frightens me, quite literally, that a parent might take a child with diabetes, or a treatable cancer, to a homeopath.
- The rejection of etiology also frightens me, given the level of improved certainty that comes with genetic and molecular medicine. I see, in homeopathic writing, a pattern of encouraging fear of medical sciences. I see the emphasis on using the word "allopath" as trying to reopen old political and just plain angry battles.
- Now, remember that this discussion has been international, in the sense that Ramanand has been bringing up Indian practices. Perhaps Western homeopaths would never do such things, but he has given me the impression that ambulances -- and yes, they might not be available in some countries -- would not be called until late or never.
- That most homeopaths are not licensed or reviewed is not very confidence building.
- I can only say that in several decades of working with health care, I have never met a physician who used homeopathic methods. I'm not saying they don't exist -- I'm saying that at least in the U.S., homeopathy does not appear to be a significant form of complementary medicine. I do know quite a few physicians that either themselves use other alternative methods, or integrate care with alternative practitioners.
- Howard C. Berkowitz 20:53, 21 September 2010 (UTC)
- OK, I may need to be more focused. There's been too much talk page discussion that doesn't have anything to do with improving the article. I'm probably especially irritable about health care at the moment, as I'm dealing with the last comfort-care-versus-euthanasia decisions for my best friend--who, incidentally, may well have benefited from some complementary veterinary medicine.
- The "wisdom of the body" discussion is the only thing I'll raise right now. While I don't see that historically as the core of homeopathy, certainly the article can say this is something in which many homeopaths believe, and define it in declarative sentences. Also in declarative sentences, it is fair to say that biologically oriented clinicians find it to have no information that will help a patient, and denies that which has been learned in over a century (well, maybe since somewhere mid-20th century) about etiology and efficacy. Neither side will convince the other, and both sides have equally intense beliefs. Treat it as a religious difference based on faith, stop trying to argue the positions in the article, and move on. Dana can say wisdom of the body is a matter of core faith for him and have it respected as such; note equal respect for the faith of the nonhomeopaths, and move to the next subtopic. Howard C. Berkowitz 22:50, 21 September 2010 (UTC)
- Howard, I'm glad that you recognize how much of your writing here is not practical to THIS article, as is your arbitrary differentiation between your "assumed" different definitions of the wisdom of the body. If one believe in evolution, I believes that organisms automatically strive to defend themselves and to survive. I could quote Hans Selye, MD, PhD, AND Walter B. Cannon (author of the classic text, "Wisdom of the Body") in many places where they assert its presence. Even MDs recognize its presence, but they tend to ignore it or have a certain disdain when treating people. Their loss. In any case, unless you can cite a reputable source for your different definitions, please STOP making assumptions and please stop making up your own defintiions. Dana Ullman 02:50, 22 September 2010 (UTC)
- I need to also say that Howard's assertion that homeopaths do not believe in "etiology" is just one more unfounded assumption he has made (no big surprise). Homeopaths simply have a more sophisticated viewpoint on etiology than Howard and reductionistic scientists do. For infectious disease, for example, we believe in germs, but we also believe in host resistence. While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence. I am beginning to think that Howard is simply unable to understand homeopathy. Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time. I look forward to Howard's contributions if he can show real intellectual effort here rather than creating straw men and creating arguments/fights when none exist. Dana Ullman 03:00, 22 September 2010 (UTC)
Strawment Produce text, not attacks
Cannon, I would note, is a 1963 book, which appears to be aimed at a lay audience. Of course, rather than the sarcastic "I could quote", a far more constructive approach would be to do so.
Please stop yelling about strawmen and propose text. Please stop making sweeping inferences such as the theory of evolution proving the wisdom of the body, which you have yet to define rigorously. "Even MDs" is meaningless without citation, and citation of current and authoritative ones. As I mentioned, it simply does not appear in the indexes major textbooks: Harrison's Principles of Internal Medicine, the Hopkins Principles and Practices of Medicine, Best and Taylor's Physiological Basis of Medical Practice, or the Guyton-Hall Textbook of Medical Physiology. My copy of Cecil's Internal Medicine does not come immediately to hand. If it is such an accepted, well-defined concept, one might think that some of the most widely used medical school textbooks might mention it, might one?
PROFESSIONALISM ALERT for {{nocomplaints}}
I am beginning to think that Howard is simply unable to understand homeopathy. Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time.
"While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence [sic]." Nonsense. B-lymphocyte and T-lymphocyte immune response are clearly host defenses, although, in some cases, immunoglobulins may be provided externally. Interleukins and other cytokines are signaling mechanisms for host defenses. Granulocyte-macrophage colony-stimulating factor deals with improving cellular responses.
Tumor necrosis factor-alpha is a host defense that frequently becomes hyperactive and needs to be returned to safe levels; the area of overactive host defenses is an important one, as in anemia of chronic disease with the fairly recently recognized roles of hepcidin and interleukin-6, or, overwhelmingly, in autoimmune disease. In other words, sometimes the body is about as wise as a teenager being challenged by peers after non-homeopathic dosages of a remedy with the (vivid) memory of ethanol. --Howard C. Berkowitz 03:53, 22 September 2010 (UTC)
Rationalwiki
I hope one of you can write an article on the retionalwiki refuting their allegations about CZ as well as the CZ article on homeopathy.—Ramanand Jhingade 15:43, 20 September 2010 (UTC)
- And why, precisely, don't you do it? I have never read Rationalwiki and have no reason to do so. I certainly won't defend the CZ article on homeopathy, because I frankly wish it were gone. Howard C. Berkowitz 16:32, 20 September 2010 (UTC)
- Unfortunately, as long as there is a CZ with which I work, I will defend its integrity -- and my first view of its integrity is that this article, and the interminable arguments to reach a "consensus" on irreconcilable ideas, continues to damage CZ. I am absolutely unconcerned with anonymous criticisms from wikis or stone tablets. Howard C. Berkowitz 10:12, 21 September 2010 (UTC)
- I quote: I am absolutely unconcerned with anonymous criticisms from wikis or stone tablets.</quote> A huge, gigantic, mega 'Hear, hear!' from me, Howard. Well said! Aleta Curry 21:39, 21 September 2010 (UTC)
- Yes, and 'hear, hear' to Howard's comments on homeopathy above, too. Ro Thorpe 22:14, 21 September 2010 (UTC)
When to refer; when to call emergency services
I'm afraid that saying a homeopath would call an ambulance when a conventional physician would call one really isn't very informative. If the person using homeopathy is a fully qualified physician, he or she may not even be beginning to use homeopathic principles in the decision. The clinician also may have more facilities and training for emergency interventions.
To make the point that is entirely possible to be specific about either referring or using special care, see examples from chiropractic. I see no reason why a competent homeopath, who claims general health knowledge, can't write a similar list. Alternatively, while we don't have a non-trauma triage list at CZ, another good starting point would be emergency room, or even ambulance dispatch, criteria for putting a patient into the most urgent category. (thinks of a couple of personal experiences when I was more or less tackled in the ER, and run into the treatment area, while still calmly giving a history). --Howard C. Berkowitz 02:01, 22 September 2010 (UTC)