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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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HOMOEOPATHY IS PLACEBO EFFECT. Fine. BUt my friends, those who say it can they show that placebo can also remove symptoms in the predecided sequence, i.e. folowing the Heing;s Law of Direction of Cure?
Dr Subhas,
I cannot immediately call to mind the research evidence for Hering's Law. However I believe it is a mistake to consider that Placebo has no direct healing action. It can certainly produce aggravation followed by amelioration

For example it has been clearly demonstrated that one can reverse the pain relief gained from placebo by using an opiod antagonist thus indicating that the placebo effect has a chemical pathway, that means that suggestion has a physical reality for the human organism.

Thus if it is possible to produce a healing response and if Hering's Law is not the exclusive property of homeopathy but actually an indicator of a true direction of healing, then surely one cannot differentiate placebo from verum on this basis alone
Dr. Jonathan,
I fully agree that it will be very wrong to deny that placebo has some healing effects. But the question I want to raise is that can placebo claim to produce effect, may be curative, in a specific direction (as in Hering's Law). Where as we all know very well that homoeopathic medicnes when homoeopathically selected and applied will produce curative effect in a given and predetermined direction.

May be we do not have (so called) scientific proof or explanation for Hering's law. But we can always have with little bit of effort a statistical records showing Homoeopathic medicnes will always follow Hering's law (if it cures) which will not be the case with placebo.

Will this serve as scintific fact if there is anough statistical data??

regards.
Dr Subhas
I would like to share some scattered thoughts about this issue:

+All (most) homeopathic prescriptions don't follow Hering. There are many cases when you witness these directions. And once this happens, usually results are excellent.

+Homeopathic healing is a dynamic process. Any right dynamic influence can effect such a healing. Let us see what Hahnemann is saying in the last aphorism about positive mesmerism!

+If he says that positive mesmerism is homeopathic - can not we deduce that it will work like a similimum. And this is just like saying that mesmerism may result in a Hering's direction.

+Any placebo, just like positive mesmerism, (if vibrating at optimum frequency) may effect a similar response.

+Enough objective statistical data is proof of the process. Of Homeopathy. And of Hering's direction.

+If science fails to find explanation of a process - the process can not be denied. If current paradigms are insufficient, we need a different model that can explain the happening.
My question is whether we have statistical data to predict the curative effect of placebo? Can we give a placebo and expect a certain percentage of cure-rate? Do we say the placebo can be used for specific types of illness? What kind of placebo can be given? Pills [studies with size and color have been done], taste, words that are given [intentions or subliminal suggestions], body gestures [hands on healing], or other modes of action.

How do we define a placebo? What do we give when a doctor prescribes a placebo?

More questions than answers today.
yes certain types of illness in certain types of indivuduals will respond to placebo
You are right. More questions than answers today.

But when asked with open mind, questions are vital. And lead to breakthroughs. All meaningful discoveries, including homeopathy, can possibly be traced to some tough questions.

Placebo as a control is known to have a predictable curative effect. All medicinal substances are tested against this placebo effect. “This Much” is the statistical expectation of recovery with placebo. To justify its therapeutic value (and adverse reactions), any substance or treatment protocol must prove to be significantly better than placebo. So, “this much” is statistical (scientifically accepted), measurable and observable placebo effect.

In fact, if a placebo effect can be shown to be more effective than an in vogue treatment protocol, it will invalidate the continuation of that protocol.

Placebos are known to regress the cancerous tumor, improve Parkinson’s symptom, depression, panic attacks, gastric and duodenal ulcers, angina pectoris, all kinds of pains. Can we say that any problem that has some physiological pathway involved may come under this category?

We are not confident of all the variables that influence the placebo effect, yet we can say that patient and doctor relationship influence it. Also the perception of the sham seems to be important. Can we say that if patient is more receptive, doctor’s relating is therapeutic and the choice of placebo fits into patient’s belief system, there will be maximum possibility of a successful outcome.

Kinds of placebos can be varied and will depend on the innovative trait in the physician. I am not sure how you would like to classify each of these: The Paper Remedy, Remedy under the pillow, raga music, hair root transmission. A homeopathic doctor who prescribes a placebo, may give any of these, or a plain sugar pill, or even a supposed homeopathic remedy/formulation. Or might be he has spent some quality time in understanding the patient and is holding on to the prescription. In the meantime, if patient starts improving – can we say that such a relationship/doctor’s personality is placebo?

Is it OK to ask another quesion altogether? What will make the placebo effect more potent? How can we be more sure of placebo effect?
Could this same patient-physician relationship apply to therapists, counselors, coaches, psychologists, psychiatrists and just about any doctor/patient inter-personal session?

Upholding the belief system and trust is high on the list for direction of improvement.
to any system...

Placebo ....works on faith and belief...
Yes Dr Nikhil
This is so. The big question however is it the faith and belief of the patient
or
is it the faith and belief of the practitioner in his/her system?

Experiment showing influence of Physician belief

Gracely et al 1985

Richard Gracely is one of the leading pain researchers in the USA

60 people who were having their wisdom teeth removed participated in an experiment designed by Dr Gracely. They were told that they would receive either placebo ( which might reduce the pain or might do nothing), naloxone ( which might increase their pain or do nothing), fentanyl ( which might reduce their pain or do nothing ), or no treatment at all.

Subjects were all recruited from the same patient stream with consistent selection criteria by the same staff.

The trick in the experiment was this: what was actually being studied was not the patients but the clinicians.

IN phase 1 the clinicians ( dentists and nurses) were told fentanyl was not yet a possibility 2nd to administrative problems (PN group)

In phase 2 which began 1 wk later clinicians were told that the problems had been resolved and now there was a possibility that the patient might receive fentanyl ( PNF group)

The difference between the 2 groups is striking. Pain after placebo in the PNF group was significantly less than pain after the placebo in the PF group.
The two placebo groups differed only in the clinicians knowledge of the range of possible double blind treatments

That is that the belief of the physician in the possibility that a therapy might work had a substantial effect on the action of an inert substance. The faith and belief of the physician infused that inert substance with pain relieving energy



....................ARINDAM
Dear All:

There are hundreds of trials about this matter...On of them is the following:

Forsch Komplementmed. 2009 Apr;16(2):105-10. Epub 2009 Apr 9.

Homeopathic pathogenetic trials produce specific symptoms different from placebo.
Möllinger H, Schneider R, Walach H.

Department of Human Sciences, University of Osnabrück, Germany.

Abstract
INTRODUCTION: Homeopathy uses information gathered from healthy volunteers taking homeopathic substances (pathogenetic trials) for clinical treatment. It is controversial whether such studies produce symptoms different from those produced by placebo. OBJECTIVE: To test whether homeopathic preparations produce different symptoms than placebo in healthy volunteers. METHODS: Three armed, double-blind, placebo controlled randomised experimental pathogenetic study in 25 healthy volunteers who took either one of two homeopathic remedies, Natrum muriaticum and Arsenicum album in 30CH or identical placebo. Main outcome parameter was the number of remedy-specific symptoms per group. RESULTS: On average, 6 symptoms typical for Arsenicum album were experienced by participants taking arsenicum album, 5 symptoms typical for Natrum muriaticum by those taking natrum muriaticum, and 11 non-specific symptoms by those in the placebo group. Differences were significant overall (Kruskall Wallis test, p = 0.0002,) and significantly different from placebo (Mann-Whitney test, p = 0.001). CONCLUSION: Homeopathic remedies produce different symptoms than placebo

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