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 You are now reading PART 1 of The Placebo Effect


Link to PART 2 | What About The Homeopathic Interview? Case Taking Techniques 

 



Please see link to video on HWC where you can comment about your response to this short interview clip.

Alan G. Phillips recently asked me:

Has anyone ever done, or can somebody do, a "study" that compare the success rate of clinical homeopathy with allopathic studies looking at the success rate of actual placebos? If homeopathy can be shown to work at a rate significantly above known placebos, that should dispel the placebo theory pretty quickly.

I think if we start with the definitions we can begin to sort out some answers. It seems that there are leanings in the definition about the effects being positive or negative; about whether the people who feel better are delusional in their sensations or that they are really improved in their medical conditions. There is no connection between mind/body states in the medical definitions. 

So, it may be even more important to define and base reactions and results upon the definition of health, healthy mind, healthy body. 

Perhaps a chart could be constructed with the different definitions. 


MEDICINENET.COM DEFINES PLACEBO EFFECT

Placebo effect: Also called the placebo response. A remarkable phenomenon in which a placebo -- a fake treatment, an inactive substance like sugar, distilled water, or saline solution -- can sometimes improve a patient's condition simply because the person has the expectation that it will be helpful. Expectation to plays a potent role in the placebo effect. The more a person believes they are going to benefit from a treatment, the more likely it is that they will experience a benefit.

To separate out this power of positive thinking and some other variables from a drug's true medical benefits, companies seeking governmental approval of a new treatment often use placebo-controlled drug studies. If patients on the new drug fare significantly better than those taking placebo, the study helps support the conclusion that the medicine is effective.

The power of positive thinking is not a new subject. The Talmud, the ancient compendium of rabbinical thought, states that: "Where there is hope, there is life." And hope is positive expectation, by another name. The scientific study of the placebo effect is usually dated to the pioneering paper published in 1955 on "The Powerful Placebo" by the anesthesiologist Henry K. Beecher (1904-1976). Beecher concluded that, across the 26 studies he analyzed, an average of 32% of patients responded to placebo.

It has been shown that placebos have measurable physiological effects. They tend to speed up pulse rate, increase blood pressure, and improve reaction speeds, for example, when participants are told they have taken a stimulant. Placebos have the opposite physiological effects when participants are told they have taken a sleep-producing drug.

The placebo effect is part of the human potential to react positively to a healer. A patient's distress may be relieved by something for which there is no medical basis. A familiar example is Band-Aid put on a child. It can make the child feel better by its soothing effect, though there is no medical reason it should make the child feel better.

People who receive a placebo may also experience negative effects. They are like side effects with a medication and may include, for example, nausea, diarrhea and constipation. A negative placebo effect has been called the nocebo effect.


What Is the Placebo Effect?

By , About.com Guide
Updated February 01, 2010


About.com Health's Disease and Condition content is reviewed by the Medical Review Board


Definition: A placebo, as used in research, is an inactive substance or procedure used as a control in an experiment. The placebo effect is the measurable, observable, or felt improvement in health not attributable to an actual treatment.

When a treatment is based on a known inactive substance like a sugar pill, distilled water, or saline solution rather than having real medical value, a patient may still improve merely because their expectation to do so is so strong. To eliminate the effect of positive thinking on clinical trials, researchers often run double-blind, placebo-controlled studies.

Fast Facts About the Placebo Effect:

  • The word placebo literally means "I will please" in Latin.
  • The first known double-blind placebo-controlled trial was done in 1907.
  • The FDA doesn't require that a drug study include a placebo control group, however, the placebo-controlled trial has long been the standard.
  • The NIH is funding several studies related to the placebo effect.

Sources: Placebo Effect, Robert Todd Carroll, The Skeptic's Dictionary, Skepdic.com, The Mysterious Placebo Effect, by Carol Hart, American Chemical Society, Modern Drug Discovery, July/August 1999: The Healing Power of Placebos, by Tamar Nordenberg, FDA Consumer magazine January-February 2000

Also Known As: placebo, placebo response, power of suggestion
Common Misspellings: plasebo, placeboo, placebo affect

 
The autonomic system controls the respiratory, circulatory, digestive, urogenital systems, and the action of the glands and hormone production and consists of two divisions known as the sympathetic nervous system and the parasympathetic nervous system. 

placebo effect
The beneficial effect in a patient following a particular treatment that arises from the patient's expectations concerning the treatment rather than from the treatment itselfThe American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

placebo effect
(Medicine) Med a positive therapeutic effect claimed by a patient after receiving a placebo believed by him to be an active drug See control group
Collins English Dictionary – Complete and Unabridged 6th Edition 2003. © William Collins Sons & Co. Ltd 1979, 1986 © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003

placebo effect - any effect that seems to be a consequence of administering a placebo; the change is usually beneficial and is assumed result from the person's faith in the treatment or preconceptions about what the experimental drug was supposed to do; pharmacologists were the first to talk about placebo effects but now the idea has been generalized to many situations having nothing to do with drugs
consequenceeffectresultupshotoutcomeeventissue - a phenomenon that follows and is caused by some previous phenomenon; "the magnetic effect was greater when the rod was lengthwise"; "his decision had depressing consequences for business"; "he acted very wise after the event"


THE FREE DICTIONARY ONLINE


Discussion Continues~> PART 2 | What About The Homeopathic Interview? Case Taking Techniques 

Tags: effect, nocebo, placebo, placebo-effect, placebo-response, saline-placebo

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I believe the situation is much more complex than most suspect.
An excellent book obtainable from Amazon.com is
meaning,medicine and the 'placebo effect' by daniel moerman.
Although he is a serious academic Professor Moerman is easy to read If you read the book through your view on therapeutics will undergo some serious changes
every type of pathy has its own place...whether the conventional or alternative...evey medicine every drug has its own role and it is high time for integerted approach..

Debby homeopathy isn't placebo ( i personally belive that)but i cant prove..it
we use placebo in practice a lot to judge whether the individual really requires his constitutional remedy
and when we give the remedy after 1 or 2 days placebo we see the remedy reaction...

Lots of people come to us after the use of conventional treatment..then if at that time(of taking conventional or modern medicine) they believe they are taking the medicine(which they know will work definitely and surely) then why doesn't it have a placebo effect then...why do they turn to us "placebo" prescribers.. ..that counts...so is it only in homeopathy does the person think that he is taking medicine????

to be honest we are not aware
in homeopathy no terms are definitely defined
no institutional based work has been done.
so we really don't know why or how but we somehow managed to find results.
the problem with homeopathy people come up with their own theories and propagate their own school of thought making students follow them...... it is high time we work at grass root levels........it is much needed...otherwise we would be extinct.....
Attached is a study done many years ago by MIchel Zala in France in which he gave placebo as a first remedy to 283 of his patients sequentially for a period of time.
Here is a small extract:
A) 4 to 6 weeks after the 35 K dose
The second visit took place between D28 and D45
Total number of cases 283
(207 men, 76 women; aged, 8 to 74)
Unworkable cases, at the follow-up visit
. “missing in action” (??) - 31
. other treatment began since D1 - 2
Henceforth, we will only consider these 250 workable cases; we will compare them with the Valerio Grandi paper [6], and with the allopathic studies
Evolvement D28-D45 Number % 250 % 160 (1) % Grandi % allop.
No change 90 36% 45.5% 65-70%
Effects of Placebo (> or <) 160 (1) 64% 54.5% 30-35%
- Unfavourable evolvement 20 8% 12.5% 11-30%
agg., without amel. 3 1.2% 1.9%
new symptoms 17 6.8% 10.6%
- Favourable evolvement 157 62.8% 98.1% 73.3%
clear amel. (35 K bis) 44 17.6% 27.5%
partial amel. 113 45.2% 70.6%
- Hering's law (transient) 1 0.4% 0.6%
(the % sum is greater than 100, the new symptoms being eventually associated with amel. or agg.)

(1) 160 is the number of patients that reacted to placebo (amel. or agg.)
Attachments:
That's great Jonathan. What a great piece of information.
..RATHER then highlighting 160 patients responding to placebo only...

here are a few more highlights which are given in the study....

1) Only 2 patients (out of 250) experienced a long lasting amelioration,

2) For all the rest of the patients, the placebo effects are uncomplete, compared to the benefits that can bring a simillimum:
- the positive action is partial or superficial; placebo does not reach the “deep suffering” of the individual
- the beneficial duration is short, lasting an average of four months.


although the study doesnt give much of the details of patients who responded to placebo ......but usually after 1st prescription......ie after the clinical consultation we find due to our talk with patients most of them slightly better.....after prescription of any drug or no drug...
but as the processes prolong we find that the response decreases and eventually the patient requires a similimum

also this study doesn't highlight on acute scenarios......would it be possible to keep a kid having acute complaints eg: bronchitis,loose motions(NOT DUE TO INDISOPOSITION) on placebo as 1st prescription ??
Dear Dr. Nikhil
You are right, I did not think too carefully about the section which I highlighted. I just took a small part of the article as I felt most people would not bother to open the attachment so I wished to give a taste of the article to encourage further reading.


At the same time. while I have seen the remedies act often enough that I feel no need to question whether homeopathy is an effective therapy or not, I do believe as I wrote earlier, that the matter is far more complex than it appears to be on the surface.

The material I post is in general derived from areas of my own interests and experience and thus from areas which I am investigating. The action of the mind ( or better the unconscious beliefs ) of both the patient and the practitioner are structural elements which play an important part in the whole totality of the experience.

Whether or not we can ever exactly determine the roles the various components play is of much less interest to me than an open minded questioning of the situation.

Thus in posting this paper I simply wished to indicate to those who have an interest that there is more to all this than meets the eye

Here is a non homeopathic record on the same topic:

A most dramatic placebo effect has been reported by Dr. Bruno Klopfer, a researcher involved in the testing of the drug Krebiozen. In 1950, Krebiozen had received sensational national publicity as a “cure” for cancer and was being tested by the American Medical Association (AMA) and the US Food and drug administration (FDA).

One of Dr. Klopfer's patients had lymphosarcoma, a generalized far-advanced malignancy involving the lymph nodes. The patient had huge tumor masses throughout his body and was in such desperate physical condition that he frequently had to take oxygen by mask, and fluid had to be removed from his chest every two days. When the patient discovered that Dr. Klopfer was involved in research on Krebiozen, he begged to be given Krebiozen treatments. Dr Klopfer did so, and the patient’s recovery was startling. Within a short time the tumors had shrunk dramatically and the patient was able to resume a normal life, including flying a private plane.

Then as AMA and FDA reports of the negative results of Krebiozen started being publicized, the patient took a dramatic turn to the worse. Thinking the circumstances extreme enough to justify unusual measures, Klopfer, told his patient that he obtained a new, super-refined, double-strength Krebiozen, that would produce better results. Actually, the injections Klopfer gave were simply sterile water.. Yet the patient’s recovery was even more remarkable.. Once again the tumor masses melted, chest fluid vanished, and he became ambulatory and went back to flying. The patient remained symptoms-free for two months. The patient’s belief alone, independent of the value of the medication, produced his recovery.

Then further stories of the AMA and FDA's tests appeared in press: “Nationwide tests show Krebiozen to be worthless drug treatment of cancer.” Within a few days the patient was dead.

Reference: Simonton O.C. et al. Getting Well Again Bantam 1978, USA ISDN 0-553-28033-3
very interesting indeed ..........

placebo does play a role what is more interesting even the pathology subsided..though cancer didn't....

here is something to ponder...about placebo controlled trials.......... a drug is tested in lab before a trial is carried out.

Now if for eg out of 100 drug vs placebo is 80:20 response ..........then isn't it possible that out of the 80 ;20 out of the 80 might just have had placebo effect so the actual may be 60:40 favouring drug........just a thought...
the idea is to define even by the "modern" school of thought what the drug effect is...
is just taking the drug confirm "drug" effect
the belief i am just taking the drug and it is bound to work will also be there in the people taking drug........(remember all individuals don't respond to the drug in practice the way they do in trials..)
i know i am sounding weird...but it might just be a possibility...
No, not that weird.

There is a large body of research on the action of placebo.
I don't want to clutter the thread with long articles but here is a URL which gives a a good overview of the topic. Some of the sources cited support your idea

http://www.wrf.org/alternative-therapies/power-of-mind-placebo.php

Here is another bit of research which is quite interesting from a homeopathic point of view - especially with respect to proving methodology. Maybe this should go on another thread but I have included it here as it arises from placebo research.

The idea that homeopathic science should try and emulate current Western methodologies with respect to the inclusion of placebo in provings and all the symptom elimination consequent upon that has seemed to me to be a quite erroneous path to follow.

In this research they demonstrate that the placebo group in the trial actually produce drug specific symptoms - that is they experience the same side effects as those who are given verum.

So, are they actually sensitives who are proving the drug? - That provers can experience symptoms without having taken the substance has been demonstrated and illustrated in the Discussion on Radium brom provings

Amanzio M, Corazzini LL, Vase L, Benedetti F.
Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy; Neuroscience Institute of Turin (NIT), University of Turin, Italy.
In analgesic clinical trials, adverse events are reported for the painkiller under evaluation and compared with adverse events in the placebo group. Interestingly, patients who receive the placebo often report a high frequency of adverse events, but little is understood about the nature of these negative effects. In the present study, we compared the rates of adverse events reported in the placebo arms of clinical trials for three classes of anti-migraine drugs: NSAIDs, triptans and anticonvulsants. We identified 73 clinical trials in 69 studies describing adverse events in placebo groups: 8 were clinical trials with NSAIDs, 56 were trials with triptans, and 9 were trials with anticonvulsants. Studies were selected of all Medline/PubMed or CENTRAL referenced trials published until 2007. Adverse event profiles of the three classes were compared using a systematic review approach. We found that the rate of adverse events in the placebo arms of trials with anti-migraine drugs was high. In addition, and most interestingly, the adverse events in the placebo arms corresponded to those of the anti-migraine medication against which the placebo was compared. For example, anorexia and memory difficulties, which are typical adverse events of anticonvulsants, were present only in the placebo arm of these trials. These results suggest that the adverse events in placebo arms of clinical trials of anti-migraine medications depend on the adverse events of the active medication against which the placebo is compared. These findings are in accordance with the expectation theory of placebo and nocebo effects.
This adds another intricate parameter to the mix. These are things that Allopathic strategist to not take into account. What they cannot see they cannot see. LOL
Yes it is so. Of course if there are things that they cannot see, there must be likewise things that we cannot see. So the question for us is not what is it that they cannot see, but what is it that WE cannot see.

Thus careful investigation of the 'placebo' effect may be at least a window into that invisible to us world.

I suspect that by the very nature of things there is always more that we cannot see than that which we can.

Actually one might ask " The placebo effect - does this explain everything?" LOL
YOU WILL LOVE THESE POWER OF TEN VIDEOS #HWC #Homeopathy
Very interesting discussion thread.

Jonathan, you seem to be saying that organic responses (healing/adverse) are dynamic.. and, a placebo with the right expectation can be a bigger healing influence than a similimum or a chemotherapy. I personally agree with this line of thinking/intuiting.

The observations cited lend validity to the window of what is possible as a future of healing.

Again, I was amused by The action of the mind ( or better the unconscious beliefs ) of both the patient and the practitioner are structural elements which play an important part in the whole totality of the experience

It is not only mind of the patient that plays a role in the experience.. mind of the practitioner also..!! Sure, it is intricate.. much more than what meets the eye.

All this about placebo is potent and promising... but it just is not saying that homeopathic effect is the placebo effect.

Homeopathic effect is the truth beyond science (of the day!)

Manoj

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