Talk:Medical uses of silver/Archive 11

Research suggested on my talk page
Another editor has suggested few research articles. Let me post just one for now.
 * http://www.jeccr.com/content/29/1/148
 * Antitumor activity of colloidal silver on MCF-7 human breast cancer cells
 * Background
 * Colloidal silver has been used as an antimicrobial and disinfectant agent. However, there is scarce information on its antitumor potential. The aim of this study was to determine if colloidal silver had cytotoxic effects on MCF-7 breast cancer cells and its mechanism of cell death.
 * Conclusions
 * The present results showed that colloidal silver might be a potential alternative agent for human breast cancer therapy.

In my opinion this article shows that:
 * 1) Cs is considered or "has been used" as an antimicrobial and disinfectant agent. (And thus cannot be "quack").
 * 2) It's further affirmed that "colloidal silver might be a potential alternative agent for human breast cancer therapy."

This article actually says "colloidal silver". If the editors will consider this source as reliable, even though this study didn't evaluate actual treatment with cs for cancer, would we ignore the researcher's conclusion? IMO it's highly unlikely that experts will recommend a "quack" substance as a potential agent. Ryanspir (talk) 12:57, 6 March 2013 (UTC)


 * Ryan, here's the deal: There are two separate and distinct uses of colloidal silver under discussion here:
 * 1) Topical application of colloidal silver for antibiotic purposes
 * 2) Ingesting consumer-marketed "colloidal silver" dietary supplement products
 * Reliable secondary sources, including Quackwatch, the FDA, NCCAM, and Consumer reports, all say that ingesting colloidal silver consumer-marketed dietary supplement products has never been shown to prevent or treat any disease or health condition. Ingesting colloidal silver consumer-marketed dietary supplement products is what is "quackery".  Until you can produce at least equally authoritative sources that say ingesting "colloidal silver", the stuff people buy as a dietary supplement, has been shown to be useful for anything other than turning your skin blue, the characterization in the article of ingesting colloidal silver as ineffective quackery will stay.  Individual primary research studies studying the topical uses of colloids of highly specialized silver compounds in petri dishes or in rats (all three studies on your Talk page, I reviewed all of them) have nothing to do with ingesting consumer-marketed colloidal silver.    15:06, 6 March 2013 (UTC)
 * And to be clear, the second study on your Talk page,, contains the sentence "The present study investigated the protective effect of colloidal silver, which is widely marketed as a dietary supplement for diseases like diabetes..." But the study itself is a petri dish primary research study in rats that found "colloidal silver" reduced the oxidative stress induced by reactive oxygen species in naphthazarin-induced cells.  MeSH terms indicate "cultured cells".  The study itself wasn't on human ingesting colloidal silver, and wouldn't be useful here anyway as it's a primary study and not a secondary source.   15:12, 6 March 2013 (UTC)


 * I'm lost here. What is the purpose of what you have written above? Ryanspir (talk) 11:54, 7 March 2013 (UTC)


 * It is a response to your suggested article content changes using the sources you provided. Such discussions are the very purpose of article talk pages.  Please read WP:TPG to learn more about what an article Talk page is and how to use it.    13:46, 7 March 2013 (UTC)


 * I have read WP:TPG per your suggestion, thank you zad. It says that one of the uses of the talk page is for communication between editors in order to reach consensus. Therefore, I'm wondering, do we have consensus that cs is not a quake substance when used externally and for disinfection?
 * I think an example could be iodine solution that is used for cuts. It's effective for disinfecting cuts, but usually people don't drink it instead of antibiotics. Ryanspir (talk) 13:38, 8 March 2013 (UTC)


 * What specific article content change are you proposing here, and using what sources?   13:43, 8 March 2013 (UTC)


 * I'm proposing to remove Quackwatch completely. I'm aware that we didn't get this result in RSN, but the consensus about cs being not quack substance in relation to external application and disinfection came after that.
 * There are variety of sources, I propose to use USFDA that separates ingestion and external application. Ryanspir (talk) 14:56, 8 March 2013 (UTC)


 * The Quackwatch articles, our DRN discussion and the article content we discussed were all about ingested colloidal silver, not topical. Sources discussing the effectiveness of topical application of CS are off-topic concerning Quackwatch.  As I mentioned above (see "Ryan, here's the deal..."), to make an argument to remove Quackwatch from the article entirely, you need to bring an equally authoritative source that says ingested colloidal silver has any benefit.  And even then, honestly, we'd probably leave Quackwatch in the article but add the new source alongside it.    15:11, 8 March 2013 (UTC)


 * Thank you Zad, I appreciate your clarification. I was under wrong impression that we were discussing Quackwatch concerning all uses. May I therefore propose to remove Quackwatch reference to the Lyme article because the article doesn't specify ingestion and doesn't contain word "ingestion"? As you have said earlier, the Research of Leeds regarding silver in cancer doesn't say "colloidal" and on this ground we didn't accept it. The Lyme article doesn't say "ingestion" either, and thus to write or imply that its concerning ingestion would be an original research. Therefore, I propose to be impartial and apply the same standards to Quack reference as we have applied to the cancer research. "(or anything else)" Would imply all uses and thus go against our established consensus. Thank you. Ryanspir (talk) 15:28, 10 March 2013 (UTC)


 * I guess you didn't read the Lyme article carefully? The Colloidal Silver section there references the FDA's statement about the "human consumption of silver", providing the scope of what it's commenting on.  Also that same section provides a link with the words "colloidal silver and silver salt preparations" to the main Colloidal Silver article, which goes into great detail about the ingestion of CS, further providing context.    02:44, 11 March 2013 (UTC)


 * The FDA reference "A 1996 Federal Register notice" in this article is outdated and fails wp:medrs. Per our consensus we agreed not to use references to old information that fails wp:medrs. The FDA advisory has been corrected in the latest FDA statement that is not included in Lyme article. The link to the main colloidal silver article cannot be considered, as per the same consensus we have agreed that we won't use it because it's outdated. And, most important, the Colloidal Silver section on Lyme's article has no any mention that it's about ingestion of silver for it's never mentioned. A reader of wikipedia will be under impression that Quackwatch disqualifies cs for all uses. Their use of words "(or anything else)" absolutely elucidate that quackwatch views ALL uses of silver as quack. That is something that absolutely contradicts our established consensus that it's only the ingestion that hasn't be accepted by the medical authorities and experts yet due to the ongoing unfinalized research. And we have also consensus that cs has been found to be effective for disinfection and external treatment and thus cannot be viewed as a quack substance in relation to these uses that are approved by FDA and EPA. What is your opinion? Why would we create a disservice to the readers by saying "Quackwatch states that colloidal silver dietary supplements have not been found safe or effective for the treatment of anything ." at the time that it contradicts our own consensus? Ryanspir (talk) 11:40, 13 March 2013 (UTC)
 * I can't imagine why you keep bringing up the phrase "quack substance" because the idea that a substance is quackery is not something anybody other than you is discussing, it is only purported uses of a substance than can be quackery. Maybe you didn't know, but for people, "ingestion" means the same thing as "human consumption".  WP:MEDRS applies to biomedical information; we are not using the mention of the FDA's statement about the "human consumption of silver" to source biomedical information, we are using that statement and others to provide the scope of the use of CS where Quackwatch says "However, no study has shown that colloidal silver is safe or effective for treating people with Lyme disease (or anything else)."  Per our WP:DRN discussion, which resulted in unanimous agreement from everyone involved - including you - that statement was found to be WP:MEDRS-compliant and acceptable to use. At this time, there is no consensus supporting your suggested change to the article, and per WP:NOCONSENSUS your suggested change will not be implemented.  Feel free to try to develop consensus for your suggested change with other editors.    13:04, 13 March 2013 (UTC)
 * Do you mean when it says in the article "Quackwatch states that colloidal silver dietary supplements have not been found safe or effective for the treatment of anything." is:
 * a) Not biomedical information?
 * b) This statement cover only ingestion? (Despite stating "..of anything")??
 * c) Even though taken from Lyme's article it actually doesn't mention Lyme?
 * In our DRN discussion I have agreed for the meanwhile to use Lyme's article because at least it is not outdated. But I have stated that I'll challenge it on other grounds. Thank you. Ryanspir (talk) 14:17, 14 March 2013 (UTC)
 * Are you stating that in the WP:DRN you knowingly agreed to the use of a source you believed to be inappropriate or in violation of Wikipedia policy and guideline? The article content says "dietary supplements" which, in my opinion, provides clear scope of the use being discussed, feel free to propose alternate wording if you feel it needs to be made more clear.   14:27, 14 March 2013 (UTC)


 * Yes, I knowingly agreed to the use of a source that I believe is to be inappropriate. And I have stated that this is just a step towards improvement, because Lyme's article at least not failing wp:medrs per date issue. The improvement I believe is to remove quackwatch completely, however, at this time I'm not even asking that. I'm just asking that the article will reflect our consensus that external and disinfection uses are not quack uses. Currently the article says "anything" and this contradicts to the established consensus. It doesn't matter that it's in the alternative medicine section, because I have said, that in most of the countries all uses of silver belong to alternative medicine. Same applies to "dietary supplements", as it's not predisposed that it will be only used by ingesting. People may use silver "dietery supplement" externally for example. Ryanspir (talk) 15:30, 18 March 2013 (UTC)
 * Wikipedia article currently states "Quackwatch states that colloidal silver dietary supplements have not been found safe or effective for the treatment of anything." and the paragraph this sentence is in starts with: "Since about 1990, there has been a resurgence of the promotion of the ingestion of purchased or homemade colloidal silver as a dietary supplement or homeopathic remedy...".  To me, context seems perfectly clear and in line with the source.  I do not support the change you are suggesting, Alexbrn does not appear to either.  Feel free to try to develop a consensus supporting your suggested change with other editors.    20:16, 18 March 2013 (UTC)

Context seems fine to me. I find it astonishing that after taking a few weeks out and coming back, this is still being worried-at by one editor, in spite of the DR that has taken place! Alexbrn talk 15:28, 14 March 2013 (UTC)
 * Why are you being astonished? In my closing comments to DR I have stated that I'll challenge all uses of quackwatch eventually. But now I don't have free time for this, so at this time I'm just asking that the article will reflect the current established consensus that zad has proposed. Kindly see our discussion about ingestion/anything. Ryanspir (talk) 15:57, 18 March 2013 (UTC)


 * Frankly, I'm not astonished that this is still going on either.   20:16, 18 March 2013 (UTC).
 * Personally, I passed my WP:SHUN threshold a while back, but I admire your patience in continuing to respond here. MastCell Talk 21:32, 18 March 2013 (UTC)
 * In this case I feel like I needed to have all my i's dotted and t's crossed, and I feel like that is complete now.   22:56, 18 March 2013 (UTC)
 * Wow! I just discovered this discussion and am rather astounded that we have someone who would intend to "challenge all uses of quackwatch eventually." Ryanspir, have you read the history of QW's usage here at Wikipedia and about similar attempts by others (resounding failure)? Do you understand why a source like QW (or even the NYT and JAMA) can be a RS for some purposes and not for others? Now if you've found it being used improperly in some place, then I'm all for not using it in that case, but a challenge of "all uses" is on its face going way too far. There is no logic in that and such a move would obviously be disruptive. No, deal with its use on a case by case basis. That's what ArbCom and others have determined is the proper procedure for dealing with its use here. -- Brangifer (talk) 17:15, 24 March 2013 (UTC)
 * The article's talk page is for discussion of the improvements of the article. It's not a venue to discuss editors. I would assume a veteran editor Mastcell should know that. It's also common not to announce wp:shun on the talk page, inside of the wp:shun it's written about it. And, broadly speaking, of course its easier to shun someone whom you disagree with. It's rather similar to "chinese draw" in chess game. That's when a player who is losing a game, removes abruptly all the chess pieces from the board :). I would also suggest that ALL pro-balance or pro-cs editors have left this page because of such non-welcoming behavior. The latest one being Blakebeau. The new editors come to this page with altruistic motives of improving the article, but soon they see that established experienced editors don't allow them to implement any changes, become frustrated and leave.
 * Regarding the para: "promotion of the ingestion of purchased or homemade colloidal" would be incorrect either IMHO. We have also a clear established consensus that purchased or homemade colloidal silver isn't necessarily bound to be ingested. So I'm proposing to rephrase all these to be in accordance with the established consensuses and make the article to say to what we have agreed so far. That is: cs can be both ingested or applied externally. And quackwatch should remove "anything" as it is obviously gives the reader the idea that ALL uses, including external and disinfection are quack uses. If Alex supports the position that ALL uses are quack, despite FDA clearance of external applications and EPA's approval for disinfection, he is welcomed to state his position. But that still would be 3:1 unless also Desoto and Zad will retract their positions. Ryanspir (talk) 15:56, 20 March 2013 (UTC)


 * Provide diffs please demonstrating that what you are perceiving as consensus supporting your proposed edits is actually true, because I think your statement about "3:1" consensus in support of it is wrong.   17:05, 20 March 2013 (UTC)


 * I know I am going to regret this, but in the hopes of moving on--Ryanspir--please make your edits. We are not here to argue with you. We are here to edit this article.  I make edits, Zad makes edits, Wdford makes edits, heck, even Blakbeau edited the article.  You do not.  As far as my position goes, I support the article as it is now.  I support the inclusion of Quackwatch.  I also support the addition of two articles in the LA Times regarding cs, but I will wait on those until I have more time.Desoto10 (talk) 03:51, 21 March 2013 (UTC)


 * ??? I don't understand, you're suggesting that Ryan make edits to the article that you don't agree with? If the article is edited to remove Quackwatch, it'll be reverted as "No consensus for this change."  I'm not sure what the value would be in that exercise.    03:57, 21 March 2013 (UTC)


 * Well, that is the way it usually works. Someone makes an edit.  Others either agree with it and it stays or they disagree and revert, then discuss.  A consensus is reached on the talk page or it moves to a higher level.  Without an edit there is nothing concrete to argue about.  But go ahead and keep arguing if you find it useful.  I am going to move on with editing.Desoto10 (talk) 04:44, 21 March 2013 (UTC)


 * I understand you now and agree, thanks.   04:50, 21 March 2013 (UTC)


 * You cannot agree with this Zad, because Desoto is wrong :). I have already removed Quackwatch and it was reverted. I shall not remove it again, because what should be done in this situation is engaging in discussion with the interested parties. That is thanks to you Zad as you have always been pointing me to the relevant Wiki policies. :) So I'm acting in accordance with these policies. I'll make a new section and provide 3:1 (actually 3:0) at this time consensus because this section is getting too long. Ryanspir (talk) 14:00, 22 March 2013 (UTC)
 * I'm retracting the comment above. After a bit of thinking I have realized that the quackwatch I have removed before, was a different reference and different statement. However, it doesn't mean that I will remove it again, though I might do so. Due to consideration that such edit of my can be reverted, I find it anyway better to have a consensus first. Ryanspir (talk) 13:34, 25 March 2013 (UTC)

Legislation
I see that most of the regulatory commentary has been moved to a new? section Legislation. Only the first two paragraphs of this section do not relate to alt.med uses. I would put the FDA approvals back with the products and put the warnings and so forth back with alt. med. Was there some compelling reason to move this information to a new section? Thanks. Desoto10 (talk) 01:26, 22 March 2013 (UTC)
 * Yes I guess it does not matter either way. Whether something is FDA approved is more bureaucratic than medical and it is US centric. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:49, 22 March 2013 (UTC)
 * I moved the altmed regulatory stuff back but left the others. I think they, too should be moved back to their respective positions but was not sure where to place them. Desoto10 (talk) 17:21, 22 March 2013 (UTC)
 * Obviously it makes sense to put the material in the section to which it refers. Hiding away some material at the bottom of the article in the hope that readers don't get that far, it not scientific and it is not neutral. Since Jmh649 seemingly doesn't think it matters either way, we now have consensus to do it properly. The FDA is not just a form-filler; it's conclusions are taken seriously around the world, the xenophobia of certain editors notwithstanding. I have moved the material back to where it belongs. Please stop suppressing this relevant and RS material. Wdford (talk) 07:04, 23 March 2013 (UTC)
 * To help those who think for some reason that FDA approved is merely a bureaucratic inconvenience: Per, to acquire FDA approval, the applicant must either provide reasonable assurance of the product’s safety and effectiveness, or must demonstrate that the product is "substantially equivalent" to another product that has already been so approved. FDA approval therefore signifies that an independent body has certified a certain level of effectiveness. The fact that the FDA is US centric does not reduce the validity thereof - the human body works the same everywhere. Wdford (talk) 22:34, 23 March 2013 (UTC)


 * I commented below, sorry I didn't see that there were responses up here. FDA clearance of medical devices, which cover dressings (which, incidentally, kind of include topical creams) does not mean effective in many cases, especially for exempt or low risk Class I products.  It means, in the case of silver-containing dressings that they are substantially equivalent to predicate devices, which were grandfathered into the system because they were in commercial use prior to 1976 wnen the current system was put in place.  Most of these kinds of products fall under the general conditions meaning that they must not be misbranded and must be produced under GMP regulations.  Clearance via the 510(k) process is a very mild approval but it is all that there is for these devices.  This is not the place for a discussion of the problems with the 510(k) process but many ineffective products have been cleared and the National Academy of Science has just issued a scathing review of the process. Desoto10 (talk) 00:50, 24 March 2013 (UTC)
 * I think the way you guys have now is fine.Desoto10 (talk) 00:53, 24 March 2013 (UTC)
 * Could you please provide some links that will describe what you are implying? And you are implying that FDA approval/clearance via 510(k) is somehow inferior. Your final point is, that a medical device (cream, bandage) can get 510(k) even though it's inefficient, doesn't cure and has no effect? Unless you provide reliable links that describe it as such, I'll see ALL FDA approval/clearances to be based on testing in independent biomedical facilities and be effective. Ryanspir (talk) 13:45, 25 March 2013 (UTC)
 * So I have waited for a few days and there are no links that has been provided. So I'm asking the editors disregard that 510 (k) is somehow "inferior" process that may allow not effective agents to be cleared. Not that I agree or disagree with his position, but as long he didn't provide the links it carries no any weight. Of course, once the links will be provided, we may accept this position. Until then, we may assume that all processes of clearances by the FDA guarantee that the approved agents has been proven to be effective. Imho.Ryanspir (talk) 15:24, 31 March 2013 (UTC)
 * Please note that unilaterally imposing deadlines at WP generally doesn't go over very well. 510(k) only requires that a device be at least as safe and effective as another device already on the market that is exempt from pre-market approval (PMA) because the latter device was marketed prior to May 28, 1976.  In contrast, the FDA states: "Premarket Approval (PMA) is the most stringent type of device marketing application required by FDA. A PMA is an application submitted to FDA to request approval to market. Unlike premarket notification, PMA approval is to be based on a determination by FDA that the PMA contains sufficient valid scientific evidence that provides reasonable assurance that the device is safe and effective for its intended use or uses." 501(k) does not involve any pre-approval inspection of the manufacturing facility, whereas PMA does.  Clearly, 501(k) is substantially less stringent than PMA.  -- Scray (talk) 16:00, 31 March 2013 (UTC)

From the IOM / NAS, the highest level of scientific expertise in the US:

http://www.iom.edu/Reports/2011/Medical-Devices-and-the-Publics-Health-The-FDA-510k-Clearance-Process-at-35-Years/Report-Brief.aspx

"When the FDA assesses the substantial equivalence of a device, it generally does not require evidence of safety or effectiveness; and when a device is found to be substantially equivalent to a predicate device, the new device is assumed to be as safe and effective as the predicate because of its similarity. Devices that were on the market before the Medical Device Amendments were never systematically assessed for safety and effectiveness—but they are being used as predicate devices. This leads the committee to find that 510(k) clearance is not a determination that the cleared device is safe or effective. The committee concludes that the 510(k) process lacks the legal basis to be a reliable premarket screen of the safety and effectiveness of moderate-risk devices and, furthermore, that it cannot be transformed into one."

This is in contrast to a PMA which requires evidence of safety and efficacy similar to that required for a drug. I believe that this justifies our current statement. Desoto10 (talk) 01:17, 1 April 2013 (UTC)


 * Yes, Scray, you are right that deadlines should be issued and as such I didn't issue one. However, there should be a reasonable amount of time within which a reply should be forthcoming, or at least an acknowledgement. Therefore I acknowledge what you and Desoto have written and will review it. However, just from a brief look: "..premarket screen of the safety and effectiveness of moderate-risk devices.." they are referring to "moderate-risk devices" . IMHO I don't think that cs falls under this category in referring to external only applications for which the 510(k) were issued. Thank you. Ryanspir (talk) 15:17, 3 April 2013 (UTC)

3:0 Consensus (possibly 3:1 if Alex will provide his position) regarding Quackwatch in relation to external and disinfection uses of silver
Zad: " Ingesting colloidal silver consumer-marketed dietary supplement products is what is "quackery"". Because the word ingesting is underlined and from the context it's clear that Zad doesn't consider other uses that are approved/cleared/shown to be effective by FDA/EPA/Cochrane reviews 2011,2012 to be quack uses.

Desoto: "The current consensus among editors is that the ingestion of cs is quackery and that the use of silver-containing wound dressings, while not overwhelmingly supported by EBM, is not quackery."

Ryan: I agree that due to FDA/EPA/Cochrane external and disinfection uses of silver are not a quackery. Ryanspir (talk) 14:08, 22 March 2013 (UTC)


 * I guess we'll just have to wait and see what article change suggestion this might be related to.   15:21, 22 March 2013 (UTC)


 * I propose to limit the quackwatch statement to ingestion only, but I think you can foresee the problems with that. Statement "have not been found safe or effective for the treatment of anything." is clearly all inclusive. It means treatment of water is quackery, disinfection is quackery and external application is quackery. That is contradiction to our consensus. If you will simply change the statement, that would be original research. If you say that by context, being in alternative medicine section and relating to dietary supplements it is somehow means ingestion (which is far-fetched IMHO) that is wp:syn, because he clearly means and says *treatment of anything*. Ryanspir (talk) 16:00, 24 March 2013 (UTC)

Turning blue - request for clarification from Zad68
"Ingesting colloidal silver consumer-marketed dietary supplement products is what is "quackery". Until you can produce at least equally authoritative sources that say ingesting "colloidal silver", the stuff people buy as a dietary supplement, has been shown to be useful for anything other than turning your skin blue."

The vast majority of cs that is sold as dietary supplement is up to 30ppm. That means 30 particles per million strength. I would really appreciate if Zad (or anyone) could provide any evidence at all that there is at least one person in the world who became blue by using these dietary supplements. I will not only accept primary, secondary or any other sources, but also registered cases and I even ready to accept anecdotal cases. I would assume that if no such sources can be provided Zad will temporary retract his position regarding this. Thank you. Ryanspir (talk) 14:27, 22 March 2013 (UTC)


 * Our reliable sources, including the FDA and NCCAM, indicate that argyria is a risk of ingesting colloidal silver. Is this related to a specific article change suggestion?    15:17, 22 March 2013 (UTC)


 * Apparently not. Desoto10 (talk) 20:59, 24 March 2013 (UTC)


 * Actually yes. It should be explained that FDA and NCCAM advisories may contain reference to "colloidal silver" that is of outdated version of cs that contain higher and much higher concentration of silver that is used today. It should be written that no matter how long time people ingest colloidal silver under or equal to 30ppm or in what doses, even if they drink entirely cs instead of water, there is no currently ONE registered case of color skin change. Ryanspir (talk) 14:46, 31 March 2013 (UTC)


 * What reliable source makes this claim that cs with less than 30ppm cannot cause problems? Desoto10 (talk) 21:40, 31 March 2013 (UTC)


 * The absence of any registered cases in which cs under or equal to 30ppm was mentioned in any medical literature in any countries of the world. Ryanspir (talk) 16:12, 3 April 2013 (UTC)


 * That is correct that there are kinds of cs that a person may have changes in the skin color after a very prolonged use. However, we are not obliged to follow FDA's opinion based on overly broad generalization. This is US specific recommendation and it's only a part of the whole picture. We should consider the whole picture and summarize it according to the reality. The FDA advisory provides too broad generalization to all kinds of silver, and that's unfair. If out of 100 brands of silver dietary supplements, there are 1-2 minor brands that produce high PPM concentration that may cause changes in the color, that is unfair to the 98 brands that doesn't produce such changes even with prolonged use. If FDA issues not specific recommendation, it doesn't mean that after we have investigated and saw there there is not one registered case of a person becoming blue in the whole world when one uses under 30 PPM concentration, we may reflect it. Also, FDA advisory was written 2009 and since that time (and even before) there is a tendency of reducing ppm across all brands of cs, by making the particles size smaller and thus allowing to maintain the same effect with lesser actual concentration of silver. Most manufacturer sell now on the internet cs that is under or equal to 30ppm. FDA advisory it's like issuing advisory against travel to Thailand, because three years ago a bomb on the south went off. So, there were never a bomb or even a threat of a bomb in Thailand North for example. So usually they will issue a right advisory against the travel in the south. But from time to time they will jump and issue advisory for the whole of Thailand, a country that is generally very peaceful, without any consideration that there is a local conflict going on only in the south.
 * My point is, a casual reader reading this article forms a strong believe, that if he buys a mainstream cs, he has a chance to develop changes in the skin color if he drinks too much of cs. This is not reality. When one uses cs under 30ppm bought on the internet, even if he drinks it everyday entirely instead of water, I'm yet to see one report of change the skin color. So, the article provides extensive generalization giving too high weight to 2% of the products and doesn't consider or reflect the safety of use of the 98% of the products. And, even in this 2% it's not automatic that people will have changes in the skin.
 * So the article induces anxiety and low-level panic among those who think that they might drink too much of cs or too long. And that is absolutely irrelevant worry, as long as it's a mainstream brand with a proper concentration. So, in this aspect the article misinforms the readers.
 * An interesting point of why FDA advisory may refer to cs as producing skin changes may stem from this misunderstanding:
 * "Q. Does the generic term “colloidal silver” have more than one possible definition?
 * A. When we use the term "colloidal silver", we use the Chemistry definition of "colloid" as a system in which finely divided [silver] particles are dispersed within a continuous medium (de-ionized water in the case of our product) in a manner that prevents them from being easily filtered or rapidly settled.


 * …But there are also definitions of “colloid” from Physiology and Pathology that have completely different and unrelated meanings to the Chemistry definition. To understand how these terms can easily be misconstrued and misapplied, particularly by governmental agencies, see below.


 * col•loid

n. 1. Chemistry. a. A system in which finely divided particles, which are approximately 10 to 10,000 angstroms in size, are dispersed within a continuous medium in a manner that prevents them from being filtered easily or settled rapidly. b. The particulate matter so dispersed. 2. Physiology. The gelatinous product of the thyroid gland, consisting mainly of thyroglobulin, which serves as the precursor and storage form of thyroid hormone. 3. Pathology. Gelatinous material resulting from colloid degeneration in diseased tissue. adj. Of, relating to, containing, or having the nature of a colloid.


 * Gelatinous/protein, saline, and nitrate based products by their very nature are much more likely to be retained and deposited under the skin tissue than products that are simply mineral and water. Products which are mineral and water are rapidly and easily eliminated by the body’s natural mineral loss via sweat and urination."
 * Now, I haven't checked yet if there is such thing as cs Physiology-Pathology definition, but it actually can make sense. Because silver under 30ppm has no gelatinous material and doesn't produce agryria. So, if FDA refers to the Physiology-Pathology definition of cs - only then their statement is true, as gelatinous material present in cs of higher concentration. But one thing has to be very clear, this is not mainstream cs and are not produced by popular brands. A person has specifically look for higher ppm concentration and that is usually for external application and with moderation for internal ingestion. Ryanspir (talk) 15:49, 24 March 2013 (UTC)
 * Is an edit being proposed? Alexbrn talk 14:57, 31 March 2013 (UTC)
 * Yes, as I have replied to Desoto on this section. Ryanspir (talk) 15:15, 31 March 2013 (UTC)

Regulatory
I see that there is a little battle going on over where to put the FDA and other regulatory stuff. My opinion is that it should go with the relevant product sections, ie., dressing clearance with dressings, topical with topical and alt. med with alt. med. I think that we need to reinforce the fact that there are approved/cleared uses and compounds and OTC quackery that has been the subject of FDA restrictions. Desoto10 (talk) 00:37, 24 March 2013 (UTC)


 * FDA doesn't have word "quackery" in the advisories. Not approved claims, means it may or may not be effective. Quackery - it is proven to be ineffective IMHO. Ryanspir (talk) 15:52, 24 March 2013 (UTC)

Warning letters
I propose to remove "The FDA has issued numerous Warning Letters to Internet sites that have continued to promote colloidal silver as an antibiotic or for other medical purposes.[56][57]" due to being outdated. Ryanspir (talk) 15:11, 31 March 2013 (UTC)


 * What, specifically is outdated? This is an historical statement of the actions of a regulatory body that oversees drugs in the US.  These actions are not subject to being "outdated" much like the banning of OTC cs in 1999 will never be "outdated".  Why don't you just update the section with the more recent warning letters that have been issued?  Desoto10 (talk) 21:37, 31 March 2013 (UTC)


 * I didn't see any recent warning letters that have been issued. But after removing the outdated warning letters you may add the new ones IMHO. References 56 and 57 are outdated. Ryanspir (talk) 14:34, 3 April 2013 (UTC)


 * I found two (and a recall) within the past three years with my first search . In any case, you cannot claim that enforcement actions by a governmental agency are "outdated".  I told you this before. Desoto10 (talk) 03:09, 4 April 2013 (UTC)


 * Ryan, please cite the specific Wikipedia policy or guideline under which you propose to remove this content.   03:47, 4 April 2013 (UTC)


 * Ok, that could be also wp:undue weight. These letters are outdated and US specific, not directly relevant to the medical use of silver at all. They are simply letters that are addressing the proposed changes to the web context of some of the commercial sites. Ryanspir (talk) 10:15, 7 April 2013 (UTC)


 * The Warning Letters are formal legal documents issued by the US government warning manufacturers and marketers that they are promoting drugs without obtaining approval. They do not expire and are never "outdated".  They are significant, notable, very serious documents.Desoto10 (talk) 03:17, 8 April 2013 (UTC)


 * Hehe, you wanted to say promoting dietery supplements in a way that contradicts USFDA regulations. What do you mean they are never outdated? We will keep them in the year 3000 as well? Allow me to respectfully disagree, they are not significant and not notable. Most of the sites have long since complied with USFDA regulations. They are moot. Being guided by undue weight, at best they could be mentioned on "colloidal silver" article in the history section. Certainly not to be included on a general article like this one. Ryanspir (talk) 13:40, 11 April 2013 (UTC)

Quackwatch - Alexbrn
Is in your opinion referring by the quackwatch to "treatment of anything" can be seen as referring only to internal ingestion? (The other section that is relevant to this issue is "3:0 Consensus.." on this talk page.) Ryanspir (talk) 12:30, 7 April 2013 (UTC)

"restore sourced material removed without good reason". Could you please elaborate? Is WP:SYN is not a good reason or you don't think it falls WP:SYN. Since you didn't participate in the discussion in the section "3:0 Consensus" I wonder why do you come to revert my edit? If you would write your opinion and it would be seen valid by the majority of the editors, I wouldn't even edit it.

Currently the situation is: The reference suggests that cs cannot by used to treat anything. That includes treatment of water, disinfecting, external application. However our consensus came to that that only ingestion is seen by the majority of the editors as the quack use. So Zad68 has said that by putting it in the alternative section and relating to dietary supplements we imply that it's only ingestion that is targeted. This is WP:SYN - "Synthesis of published material that advances a position". "Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources." Therefore it's ought to be removed IMHO. Thank you. Ryanspir (talk) 14:45, 3 April 2013 (UTC)


 * See above (ad nauseam). I don't see a change in the firm consensus that QW merits inclusion as is. There is no SYN, the QW meaning is clear to any reasonable reader. Alexbrn talk 15:22, 3 April 2013 (UTC)


 * Agreed.   15:34, 3 April 2013 (UTC)


 * If you[plural] mean there is no SYN, that means that Alexbrn implies that indeed cs is a quack substance for treatment of anything, including external application and including water treatment and disinfection. This determination contradicts that of USFDA, EPA and many other researches that showed that cs is active in-vitro. I have posted at least 15 PMID such articles, some of them are secondary sources. I think those facts are indisputable.
 * But most importantly, it contradicts the 3:1 consensus that has evolved *after* completion of the DRN.
 * I don't see also why Zad68 approves Alexbrn's position because he has stated that he views cs as a quack substance only in relation to ingestion. Perhaps Zad68 could be kind to explain. Thank you. Ryanspir (talk) 16:10, 3 April 2013 (UTC)
 * Ryan &mdash; I think your interpretation of QW is unreasonable, and I don't recognize this 3:1 consensus (whatever that means) you keep mentioning. If you really think the context of the QW article is insufficient, the solution (as I wrote on DRN) is to cite both QW articles. Alexbrn talk 16:50, 3 April 2013 (UTC)


 * Agreed. This subject has already been addressed to exhaustion and no further response to Ryan is necessary on this subject.    16:56, 3 April 2013 (UTC)


 * I'm lost here by what do you mean that my interpretation here is unreasonable. I truly believe that the quackwatch says that ALL uses of cs are quack uses. Including external, water treatment, disinfection. He uses word "anything" that is an indefinite pronoun that is "any thing". You (pl) are somehow implying that he means only ingestion, but he didn't say that. So my understanding is a direct understanding, I'm not applying any interpretation. If he would say "ingestion", I would refer to that. If he would say "treatment of systemic diseases" I would refer to that. In any case, I'm suggesting to invite an independent comment on this matter. Thank you. Ryanspir (talk) 09:47, 7 April 2013 (UTC)


 * I have added the rfc, hopefully did it right. :) Ryanspir (talk) 12:30, 7 April 2013 (UTC)

Los Angeles times
"The Los Angeles Times claims that "...colloidal silver as a cure-all is a fraud with a long history, with quacks claiming it could cure cancer, AIDS, tuberculosis, diabetes and numerous other diseases". "

Removed reference to non WP:MEDRS complaint source. If The Los Angeles Times would say that cs can cure everything, would be put such a reference?

Just in case someone would want somehow to keep this reference, then I would propose to counter-balance it with any article in the world press that mentions cs as being successful for any of the above mentioned conditions. But I don't think that can be a good idea, since Encyclopedia such as Wikipedia cannot be built on using newspapers articles especially in case of a general article on medicinal uses of Silver where we would like to cite reliable sources according to WP:MEDRS. Ryanspir (talk) 15:00, 3 April 2013 (UTC)


 * Personally I'm OK with this being removed.   15:02, 3 April 2013 (UTC)


 * I'm not necessarily going to argue in favor of keeping that specific reference, but I think it is worth noting that the policy does not entirely prohibit referencing the popular press in such a manner. Instead, it just says not to rely exclusively on such a reference. Quote: "A news article should therefore not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source, ... Conversely, the high-quality popular press can be a good source for social, biographical, current-affairs, and historical information in a medical article." (Italics added.) Here it seems that the referenced article is just saying that the idea of CS as a cure-all is wrong and has a long history of quack claims. To me, that doesn't seem too dubious. (But I would suggest to change "claims that" to "said that" per WP:CLAIM.) —BarrelProof (talk) 18:57, 3 April 2013 (UTC)


 * That's an accurate reading and application of our guidelines. To expand on what I said, I personally don't care one way or the other if that LA Times article stays, we already have enough other, better-quality sources that say the same thing.    19:24, 3 April 2013 (UTC)
 * The high-quality popular press is a suitable source for material about the regulatory and marketing aspects of a drug or substance. WP:MEDRS says as much, so I'm a bit baffled by Ryanspir's assertion that using the Los Angeles Times in this manner violates that guideline. Just as we cite the New York Times in our coverage of the Vioxx debacle, we can cite the L.A. Times to support the fact that modern marketing claims associated with colloidal silver are often dubious or outright fraudulent. MastCell Talk 22:52, 3 April 2013 (UTC)
 * The degranulating one is correct. The LA times is commenting on the general marketing of a suspect product as a cure-all.  PubMed articles are unlikely to comment on this sort of thing because scientists are rarely interested in marketing tactics, but it is important, notable, and from a highly respected source.Desoto10 (talk) 02:50, 4 April 2013 (UTC)
 * "degranulating"? Did you mean "deregulating"?    03:00, 4 April 2013 (UTC)
 * No, I think it was a play on my username (mast cells contain granules full of histamine and other chemicals, which are released in response to a variety of stimuli). MastCell Talk 03:59, 4 April 2013 (UTC)
 * Too smart for me! That went right over my head.    12:54, 4 April 2013 (UTC)
 * (e/c) MastCell, yes absolutely, everything you stated is true, and there's nothing in WP:MEDRS to prohibit the use of that LA Times article here. It's just that the LA Times article itself isn't particularly informative, and essentially all the information from it can already be sourced elsewhere to more authoritative, clearly medical sources (and so would be much harder to unseat from the article).  Maybe I should have been more clear:  Ryan is trying to make an incorrect argument in saying that WP:MEDRS indicates the LA Times article shouldn't be used.  I don't have a strong opinion one way or another on its use here, not because of any WP:MEDRS problems, but only because it isn't necessary to use here, and removing it would increase the overall quality of the article's sourcing (slightly). While we're talking about it, the LA Times is actually being misrepresented here: our current article content says "The Los Angeles Times described colloidal silver as 'a fraud with a long history...'" but the LA Times has a qualifier in it we're not representing, the LA Times says: "colloidal silver as a cure-all  is a fraud".  So if we're keeping the LA Times, that should be fixed, because not every use of colloidal silver is fraudulent:  Our article says that colloidal silver historically had a legitimate external use as a disinfectant and still can be found in use in water purification systems for third-world countries developing nations, and the sourcing for that content seems acceptable.    02:55, 4 April 2013 (UTC)
 * Well look at that, while I was typing this, Desoto went ahead and actually fixed it in the article!   02:59, 4 April 2013 (UTC)

I apologize for the misrepresentation. It was not intentional. I like your revision to the entire quote better, anyway. Desoto10 (talk) 19:57, 4 April 2013 (UTC)


 * Great, no worries, I had no idea you added it in the first place...  20:10, 4 April 2013 (UTC)


 * wp:medrs Allows to add newspaper articles that provides layperson wording for otherwise scientific founding. However, the FDA, NCCAM and Quackwatch that are already included in the article are written in layperson wording, so this article doesn't add anything new IMHO. All it does is that it opens the door for inclusion of news articles from quality newspapers such as Los Angeles Times that will have positive articles on silver use for treatment of diseases. Therefore in order to balance, such articles would have to be included too IMHO. Ryanspir (talk) 10:01, 7 April 2013 (UTC)

Dubious claims
"The high-quality popular press is a suitable source for material about the regulatory and marketing aspects of a drug or substance. WP:MEDRS says as much, so I'm a bit baffled by Ryanspir's assertion that using the Los Angeles Times in this manner violates that guideline. Just as we cite the New York Times in our coverage of the Vioxx debacle, we can cite the L.A. Times to support the fact that modern marketing claims associated with colloidal silver are often dubious or outright fraudulent. MastCell Talk 22:52, 3 April 2013 (UTC)"
 * Allow me to respectfully disagree. There is a big difference between unproven claims and dubious/fraudulent claims. Could you please back it up with secondary sources that are based on research that has found silver for ingestion dubious, ineffective or fraudulent? So far I have only seen seen secondary sources concerning argyria, but this is unrelated to the studies of effectiveness. Even FDA advisory doesn't say dubious/fraudulent, but rather uses the statement that is confirming to the reality - "unproven", in relation to ingestion. But I'm sure if you could provide a reliable secondary source, that would validate your point. I would say more than two primary studies or a secondary study in which patients would be administered placebo and silver (cs) for any of the conditions mentioned in LA Times and would have similar efficiency (near 0) would splendidly prove your point. Ryanspir (talk) 12:09, 7 April 2013 (UTC)


 * This issue is a bit disturbing. Primary research published in medical journals has been banned from this article because it is not of a high enough quality, despite their use being authorized by WP:MEDRS, but now newspaper articles written by journalists are considered to be reliable sources, even though their use is discouraged by WP:MEDRS. Should we not demand quality secondary sources as the minimum here, as has been done elsewhere in this article? Wdford (talk) 15:48, 7 April 2013 (UTC)
 * We would not use the LA times for medical claims but we may to discuss marketing issues. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 16:14, 7 April 2013 (UTC)
 * And let's be clear: primary research has not been "banned" from this article. A small group of editors are trying to cherry-pick primary research in order to undermine or "rebut" the conclusions of reliable secondary sources. The inappropriate use of primary research is being rejected here, and the appropriate use of high-quality popular-press sources is being affirmed. Both are consistent with the letter and spirit of WP:MEDRS. MastCell Talk 17:29, 9 April 2013 (UTC)


 * Yes, I agree with the MastCell regarding primary sources. However it's Zad and Doc James that insist on secondary sources. Popular press considered even of lesser quality than primary sources. Ryanspir (talk) 13:27, 11 April 2013 (UTC)

Marketing issues
This article's name doesn't provide for inclusion of marketing information. If needed an article called marketing of cs may be created. This article however should include only medical information based on reliable sources per medrs. For this matter, all regulatory and marketing information should be removed. As a result the quality of the article will improve. Fda letters, la article that is poorer source than primary studies, supreme court decisions and bunch of other information that is off-topic should be removed or moved to other articles imho. Ryanspir (talk) 16:51, 9 April 2013 (UTC)
 * "only medical information" - why? The topic scope is wider than "medical view on medical use of silver" I'd have thought. (Though of course such medical views - properly included - must conform to WP:MEDRS). — Preceding unsigned comment added by Alexbrn (talk • contribs)
 * Disagree as well, current content fits appropriately under current article's scope. I disagree with the proposal to remove any of it.  But feel free to create a new article Marketing of colloidal silver products if you can find sufficient sources to fill it out.   17:11, 9 April 2013 (UTC)
 * There is room in this article for a section describing marketing, assuming that reliable source can be found. I don't think it is a good idea to create a content fork of this article such that the critical material is excised. Binksternet (talk) 17:22, 9 April 2013 (UTC)
 * Agree, to be clear, I'm not supporting the removal of any content as proposed.   17:30, 9 April 2013 (UTC)
 * We used to have a separate article entitled "colloidal silver", which dealt with the efficacy, side effects, and promotion of colloidal silver in the alternative-medicine world. I could envision re-creating "colloidal silver" as a standalone article, which would include both medical and marketing information. I don't think we need Marketing of colloidal silver products, because I don't see that we've reached the point where we need such a narrowly detailed sub-article, and because I'm concerned that some editors are trying to game the system in trying various approaches to siphon off, mitigate, or remove well-sourced material which is less than positive about colloidal silver (per WP:POVFORK). MastCell Talk 17:36, 9 April 2013 (UTC)
 * Surely you are not asking that we remove the regulatory status information for a medical product? Why, that would be just like wanting to remove the requirement for scientific evidence to demonstrate efficacy.Desoto10 (talk) 20:32, 9 April 2013 (UTC)
 * Yes Desoto. I'm proposing to remove all country specific regulatory information that is not supported by reliable secondary sources. I approve keeping all country specific regulatory information that is backed by secondary sources. The article named "Medical uses of silver" should foremost contain related information on topic. I don't think letters to some sites in USA more than 10 years ago are suitable for a general article as this one, for example. And in view of this, I agree with the proposal of MastCell, since all that regulatory information/marketing info that is unsuitable for a general article like this one could actually be included in "colloidal silver" imho. Ryanspir (talk) 13:21, 11 April 2013 (UTC)


 * What proposal from MastCell are you agreeing with?Desoto10 (talk) 16:37, 11 April 2013 (UTC)


 * "I could envision re-creating "colloidal silver" as a standalone article, which would include both medical and marketing information." Ryanspir (talk) 16:53, 12 April 2013 (UTC)


 * I think that would be a very bad idea. Desoto10 (talk) 20:57, 12 April 2013 (UTC)


 * I agree with Desoto.Blakebeau (talk) 23:07, 12 April 2013 (UTC)


 * Why it would be a bad idea? We could concentrate there all regulatory, anecdotal, marketing information that is related to cs. Such information is undueweight in a general article as this one. An example would be are the FDA letters that were issued towards specific products. Zad has said that we won't be mentioning any specific products as it's undueweight in a general article like this one. Ryanspir (talk) 13:45, 17 April 2013 (UTC)


 * Ryan, regarding "Zad has said that we won't be mentioning any specific products as it's undueweight in a general article like this one.": I request that you do not make any mention of what you think my opinions are about anything.  If you want to refer to something I have said, please provide a diff or a link to the conversation that includes what I said in content.  Do not attempt to paraphrase.  Thank you.    13:55, 17 April 2013 (UTC)

What you are suggesting, Ryanspir, makes no sense. We cover all of the relevant information in the current article which is not overly long. There are no notable specific products or companies in this arena, anyway, so what does that have to do with anything? Desoto10 (talk) 18:39, 17 April 2013 (UTC)


 * There are two cs products that are currently being used in USA and cleared by FDA for external use. If to go along your position that all relevant information to be covered here, I would suggest to include information about these products. Ryanspir (talk) 09:49, 22 April 2013 (UTC)


 * Only two cs products? Why are they notable?Desoto10 (talk) 17:47, 22 April 2013 (UTC)

LA Times
Removed per emerged consensus: of Zad: " but only because it isn't necessary to use here, and removing it would increase the overall quality of the article's sourcing (slightly)." Wdford supports and I support. Ryanspir (talk) 13:33, 11 April 2013 (UTC)


 * You are misreading consensus. To be clear, as I said, "I personally don't care one way or the other if that LA Times article stays" and "I don't have a strong opinion one way or another on its use here" so my input cannot be taken as support for its removal.  This is WP:NOTAVOTE but if we are counting noses, only Ryan and Wdford are actively supporting its removal.  MastCell, Desoto10 and Doc James are actively supporting its inclusion.  There is no clear consensus to remove it and I'd suggest you self-revert your removal of content under active discussion and with no clear consensus to do so.    13:41, 11 April 2013 (UTC)


 * The two quotes you have mentioned are the earlier ones. Your latest quote is: "but only because it isn't necessary to use here, and removing it would increase the overall quality of the article's sourcing (slightly)." So I have sided with you on this point that it's removal would increase the overall quality (slightly). Ryanspir (talk) 15:09, 11 April 2013 (UTC)


 * Sorry if you were misled. I have made my actual thoughts on this clear in my previous post.  Feel free to try to develop consensus for your change with the other editors.    15:12, 11 April 2013 (UTC)


 * Are you withdrawing your quote "but only because it isn't necessary to use here, and removing it would increase the overall quality of the article's sourcing (slightly)."? Ryanspir (talk) 15:53, 11 April 2013 (UTC)


 * BTW: I really liked this one: "we are counting noses". Well, sometimes it's indeed fun. Ryanspir (talk) 15:54, 11 April 2013 (UTC)


 * Glad you liked my turn of phrase. No I am not withdrawing my quote.    16:28, 11 April 2013 (UTC)


 * Hehe. Ok, thanks for not withdrawing, because I agree with you on this point. BTW: I think I missed one important point regarding QuackWatch (and perhaps some other sources like NCCAM). Some of them say that cs is not effective. (Differs from FDA advisory that says 'not proven to be effective'). But I don't see any reliable secondary sources of an actual research that would find cs to be ineffective (for ingestion). WP:MEDRS requires that whenever sources other than secondary articles are being used, in order to be mentioned, they need to be adjunct to reliable secondary sources. Ryanspir (talk) 16:51, 12 April 2013 (UTC)


 * Quackwatch and the NCCAM are indeed reliable secondary sources for this information. Ryan, see WP:DEADHORSE and WP:TE. You are treading on very thin ice here, community patience with you on this topic is nearly at an end, and if you keep at it, we will be having a discussion at WP:ANI requesting that you be directed to edit articles in other topic areas.    17:07, 12 April 2013 (UTC)


 * There is a consensus that removal of this LA Times article will increase the quality of the article. Isn't this is our goal to improve the quality of the article? Why would we intentionally keep references for which there is a consensus that it decreases the quality of the article? Ryanspir (talk) 17:51, 12 April 2013 (UTC)
 * First of all, there does not appear to be any such consensus. Secondly, please be aware that your assessment of consensus may be complicated by the fact that at least one editor (me) has chosen to limit further interaction with you, due to what I feel is your unwillingness to heed or consider anyone else's input and your disregard for this site's content policies. MastCell Talk 18:31, 12 April 2013 (UTC)


 * I, too, see no consensus for removal. Desoto10 (talk) 20:52, 12 April 2013 (UTC)


 * Following discussion on WP:MEDRS there is a consensus to use only secondary sources, and adjunct primary sources. La Times is considered a primary source and there is no secondary source (a secondary source summarizing research that proves that cs is not effective for the listed conditions. In addition, Zad68 has decided not to withdraw his opinion that removal of this reference will increase (slightly) the quality of the article. I and Wdford are siding with his opinion. Ryanspir (talk) 12:41, 13 April 2013 (UTC)
 * You seem to be alone (and therefore not representing consensus) on this point. Please allow that discussion to settle (i.e. establish genuine consensus) before applying conclusions here. -- Scray (talk) 17:16, 13 April 2013 (UTC)
 * Agreed, no consensus for removal. Yobol (talk) 17:49, 13 April 2013 (UTC)


 * I have changed my mind and I now actively support keeping the LA Times article. I have carefully considered the arguments of MastCell and others concerning the value of the LA Times article and find them convincing.  The LA Times article is a high-quality source for the type of information it provides and its inclusion raises the overall quality of the article sourcing.    03:47, 14 April 2013 (UTC)

Quackwatch
  17:59, 12 April 2013 (UTC)


 * Have create a new section as your comment was off-topic. About deadhorse - I'm not repeating the same arguments. Ryanspir (talk) 17:55, 12 April 2013 (UTC)


 * I have retracted uniting NCCAM and Quackwatch since they are different. So according to my latest discussion on wp:medrs there is a strong consensus not to use orphaned primary sources. Actually LA times and Quackwatch are similar on this point. Both are considered as primary sources and should be included only as adjunct to a secondary reliable source per the discussion on WP:MEDRS. This is a new argument that came in light during recent WP:MEDRS strong consensus.Ryanspir (talk) 12:50, 13 April 2013 (UTC)
 * You seem to be alone (and therefore not representing consensus) on this point. -- Scray (talk) 17:14, 13 April 2013 (UTC)
 * Agreed, no consensus for removal. Yobol (talk) 17:48, 13 April 2013 (UTC)
 * Agree with Yobol and Scray that there is no consensus for removal of LA Times, NCCAM, and/or Quackwatch.66.120.181.218 (talk) 22:30, 13 April 2013 (UTC)Desoto10 (talk) 03:13, 14 April 2013 (UTC)
 * Yes, the content should stay for reasons which have been repeatedly stated previously. Alexbrn talk 03:20, 14 April 2013 (UTC)
 * Ryan you appear to be saying that the LA Times article and Quackwatch are primary sources, and based the idea that "orphaned" primary sources (meaning, primary sources not used alongside a secondary source that discusses them), they should be removed from this article. This argument is flawed because the LA Times article and Quackwatch are not primary sources.    04:14, 14 April 2013 (UTC)


 * I remember in one of the discussions it was mentioned that LA Times article by itself is considered as [a poor] primary source. Because by itself it's not a research and in virtue of absence of reliable secondary sources it's not based on research thats why I guess it was mentioned as poor. However, as you say it's not a primary source, what is it then? Ryanspir (talk) 14:30, 15 April 2013 (UTC)


 * Ok, here it is, have found it. It's right in the WP:MEDRS - "The popular press is generally not a reliable source for scientific and medical information in articles." "For Wikipedia's purposes, articles in the popular press are generally considered independent, primary sources." Thank you. Ryanspir (talk) 14:37, 15 April 2013 (UTC)


 * The LA Times piece is not being used to support biomedical information; its chief topic is how "the FDA and FTC target peddlers of colloidal silver and other potentially harmful products". The statement quoted from it relates to the long history of fraud associated with colloidal silver. WP:MEDRS states that "the high-quality popular press ..." [in which we might count the LA Times] "... can be a good source for social, biographical, current-affairs, and historical information in a medical article." (my bolding). Alexbrn talk 14:59, 15 April 2013 (UTC)


 * Yes, support Alexbrn. However the article says its a quack, meaning that it's not effective for the prescribed conditions and that is biomedical information. Ryanspir (talk) 15:14, 15 April 2013 (UTC)


 * The LA Times is relaying that as the position of the US regulatory authorities, making it a secondary source in this respect. Alexbrn talk 15:24, 15 April 2013 (UTC)

Please allow me to respectfully disagree with your opinion. The US regulatory authority is FDA. http://www.fda.gov/Food/RecallsOutbreaksEmergencies/SafetyAlertsAdvisories/ucm184087.htm that is their advisory regarding cs. There is no mention that they consider cs to be ineffective.

Also:

1) May I also bring your attention, that even if some regulatory authorities would call cs ineffective without actual clinical trials that would be a speculation. 2) Even if US FDA would decide without clinical trials that it's ineffective we couldn't include it in the article, because expert's opinion is not a secondary source and it is US centric. However this clause if moot since US FDA hasn't stated they see cs as ineffective.

Per WP:MEDRS and in my humble opinion we should not use any primary source without adjunct secondary source to imply that cs is not effective. That is why I'm supporting the motion to consider cs at this time as 'not proven to be effective' due to the fact that there are no secondary sources proving that cs is effective either.

We ought to consider a big number of anecdotal reports where people would get benefits due to using cs IMHO. There are millions of cs bottles that have been consumed by hundreds of thousands of people around the world for the last 20+ years. Many of them use cs again and again and swear by it. Do you think its possible that all of them experience placebo effect and are being illusioned towards some non-existent efficiency? Even if we would assume that somehow very big number of people are experiencing placebo effects, how about the animals that were cured using cs? They don't have placebo effect AFAIK :). Ryanspir (talk) 13:35, 17 April 2013 (UTC)
 * From the article: "In 1999, the FDA banned claims of therapeutic value for over-the-counter colloidal silver products." Alexbrn talk 13:48, 17 April 2013 (UTC)
 * Banned claiming, it doesn't imply that it's considered ineffective. Currently it's considered 'not proven to be effective' by USFDA towards ingestion. Meaning that it is in their opinion that it may or may not be effective and no determination has been made towards either, thus one shall not make claims. In fact, all dietery supplements that are sold in the USA has been banned from claiming, that doesn't mean that they are not effective. Ryanspir (talk) 15:02, 17 April 2013 (UTC)
 * Right, so selling this stuff (how far unproven shades into disproven is a matter of opinion) is, ipso facto, quackery – in line with what is quoted from the article. As had been said, this is a WP:DEADHORSE. Your continued return to this topic is a case of WP:IDHT in my view. Alexbrn talk 15:37, 17 April 2013 (UTC)


 * Allow me to respectfully disagree. All dietery supplements cannot claim therapeutic effect. However Zad has said there are 8000 articles on PMID for alternative medicine. Some of them are reliable secondary reviews that are proving effectiveness. An example could be st. John's Wort. However even in the presence of reliable secondary sources they are banning from claiming. So, as you can see banning from claiming isn't correlated and predisposes that FDA consider them ineffective. Being banned from claiming doesn't imply that FDA see it as ineffective. And, as I have said, that even if they would do, that would still be moot, because experts opinion that is not came as a result of clinical trials is a mere speculation. But again, the US FDA do not say that. Thank you. Ryanspir (talk) 12:54, 18 April 2013 (UTC)


 * Ryan, regarding "However Zad has said there are 8000 articles on PMID for alternative medicine.": I request that you do not make any mention of what you think my opinions are about anything.  If you want to refer to something I have said, please provide a diff or a link to the conversation that includes what I said in content.  Do not attempt to paraphrase.  Thank you.   12:57, 18 April 2013 (UTC)


 * Regarding shading I don't agree with it. Unproven is uncertainty, disproven is a certainty. If we would like to use primary sources we need secondary sources backing it with certainty per WP:MEDRS. We cannot chain it like that: 1) consider that experts body opinion is a secondary source. 2) Then consider that unproven means disproven. That is wp:syn in my humble opinion. The issue is not a deadhorse, as there is ongoing discussion about using primary sources on wp:medrs and wp:med. Ryanspir (talk) 13:33, 18 April 2013 (UTC)