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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 

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Replies to This Discussion

From the day one, I am screaming "We should not waste our time with irrelevant arguments with opponents of homeopathy rather we should find the answers of those questions which are raised. We should waste our time in carrying out research work in homeopathy and provide the answers in that LANGUAGE that they understand or accept"

Today you are saying “I think if we start with the definitions we can begin to sort out some answers.” is the right approach


Here are the research thesis submitted to State Law Minister


Dear Dr Mas. What is written in these volumes? How can the world homeopathic community make use of these documents? Will anyone listen?
Debby said "What is written in these volumes? How can the world homeopathic community make use of these documents? Will anyone listen?"

Dr. MAS:

Dear Debby

These heavy books are five in numbers. The Research work is done keeping in view of the background and scenario of homeopathy in Pakistan. It is actually the answers of those questions, which were raised by Pakistani Ministries or officials on homeopathy and homeopathic medicines. The work is carried out and to accomplished a task in that Pakistani background. I have no idea whether it may be helpful to anyone else. I have no copies of thesis. I requested to Dr. Hafiz Matie to make copy of those thesis and bring with him for Islamabad meeting to be presented to National Institute of Health (NIH), National Council for Homeopathy (NCH) and Ministry of Law (MOL). Heavy expenditures were incurred for making genuine duplicate copies after issuing from the concerned libraries. I am very thankful to Dr. Matie for bearing all expenditures. Now if anyone who is interested in getting the copies can contact Dr.Matie hafizmatie@yahoo.com I have no idea how much it would be cost?

But its not my point, my point was, my ministries and institutions demanded to prove that homeopathy does work or show efficacy of homeo medicines in the light of so called placebo trial studies, famous DBC Studies and lab tests etc. What we did? We have put their mouth shut by completing all their requirements…. Now how much it is authentic? Whether is all fraud or genuine?

It is non our business because the trial are conducted by GOVERNMENT RECOGNISED UNIVERSITIES AND HIGHER EDUCATION COMMISSION AFFILIATED INSTITUTIONS. One more clarification, Higher Education Commission is the last authority in Pakistan on University matters and institution affiliations. It also designed curriculum and alternative medicine (homeopathy) has been added in veterinary syllabus. That step was also completed first before carrying out the study.

So if anybody raise finger on the work done, then actually we are not involved. The Supervisors were HEC approved. They got their Ph.D degrees from UK and foreign universities. Universities are also HEC approved. NARC Research Laboratory is running Government not under me. All work is done under Government recognized establishments.

So when we submitted thesis at any office, after reading the work, no one raise single question. All have accepted it. Yes, only World Trade Organization (WTO) office again issued order to its independent team to check efficacy again just to prove one more time. Its result was again excellent. Again we were not involved at any stage to persuade or influence the Research Group. Open trials were conducted by the WTO appointed professors and again good efficacy result almost 100% was obtained.

Field Study at Buffalo Research Institute under WTO

Glimpses

Students of University of Vet & Animal Sci UVAS are keenly observing the trial. The trial was conducted for many days.
The animal studies proved the efficacy of homeopathy using double-blind clinical trials with excellent results on sick animals? And, please tell us were scientists, veterinarians, field researchers, university professors the ones determining which remedies to use in each condition? If so, did they give a remedy per condition or were they knowledgeable about symptom analysis and miasms; or by what method were remedies selected?

Were animal trials enough to satisfy authorities that homeopathy also works on humans?
Dear Members

Here is yet another angle. --

In Hahnemann's times a proving was conducted in the following way:

1) All known effects of a substance were gathered
2) A low dose was taken to test, it was a material dose. These symptoms were recorded, also when and the way they follow each other. this gave them a guideline.
3) Then a low potentised does was tried. this gave them further information. they did not take each and every thing felt after the application of the dose they took as being related to the substances action, -- Only things coming along as concommitants to the previously establiched symptoms were admitted.
4) they did provings with 6C later with 30C potencies and continued to add symptoms to the list in the same way.
5) they also added symptoms from clinical experience. Those were symptoms the patient experienced during the curative action of the remedy which were unrelated to the patients disease-symptom-picture. Once the remedy stopped acting, those symptoms went by themselves. this should not be mixed up with cured disease-symptoms, which are used for clinical confirmation.

IMO: If we return to this protocol of proving medical science would find it easier to aprove of our doing. It should also be born in mind, that homeopathy can be practiced with material doses. this does not falsify the homeopathic principle.
Thanks Hans
Very interesting.
Maybe you have more info on Hahnemann's original methodologies around provings in posts which I have missed?
In any event if its not there already this and any other info you have around this should be in the provings discussion.
Take care
Jonathan
Dear Dr. Shore,

If I may join in the discussion :).

The points that you have raised is

1. How to differentiate “placebo” effect from that of “homeopathic remedy” effect?
2. Where do psychology and somatic memory meet or depart from each other? or rather how to differentiate between them?

My take on this is as follows:

1. How to differentiate “placebo” effect from that of “homeopathic remedy” effect?

A precisely selected “similar” homeopathic remedy has to act on psychological as well as physical symptoms, reason being, according to Dr.Hahnemann and other homeopaths, everything begin in mind (psyche) and then based on patients constitution, the weaker part gets affected, finally developing into a physical malady. So it is the “continuum” of mental symptoms on to physical plane.

Homeopaths give placebos in the interim when the homeopathic remedy has been administered. In my view point this placebo is helping the remedy in “continuation” of the good effect “status equilibrium” that the remedy has began on the mental and physical plain. In short “placebo” provides the homeopath and the patients (mind, body and spirit), the time required for healing of the organism.

It is well known fact in homeopathy that, “the symptoms should disappear in the reverse order of their appearance”, simply meaning the last symptoms are the one’s that should disappear first. So a physical complaint should disappear first after giving the remedy and this is observed solely by the psychological indication of the remedy on the patient.

So a patient will come back with two options, and they are,either:

a. My problems are gone/going away with over all happiness (at mental level)
b. My problems have gone worse but I am feeling ok (this is the most important indication).

Feeling mentally OK whether the physical symptoms have changed or not, is usually “give away” in a homeopathic treatment.

In both conditions, homeopath has nothing to do, as in first scenario, the remedy has acted on both planes simultaneously, where as in second option the medicine has acted on psychological aspect and has aggravated the problem and in due course will take care of physical symptoms.

So the placebo effect is used to aid the homeopathic remedy action going on.


2. Where do psychology and somatic memory meet or depart from each other?

Once again it is the “continuum” as to really where one ends and the other begins. Analogy provided by Debby is a good example, feeling nauseous after seeing the food that caused that nausea in first place (law of similar is everywhere to see for), can be further elaborated and applied to every aspect of human life.

Mere mentioning of words like ice-cream, pizza makes the taste buds and salivary glands to salivate, so memory is in mind but the effects will be physical. It is all genetics. The psychology is “ genotype” and organ symptoms are its “phenotype”

I may have just blabbered too much, but hope you got the idea I wanted to convey.

Regards,

SK
I was tempted a couple of days ago to separate this thread out into different conversations because it has veered off into so many directions. But, in a way it seems to have come back to the theoretical idea of whether placebo explains homeopathy. Maybe we could say, "Does Homeopathy Explain Placebo!" Now, isn't that a switch?

But, I am learning that sometimes by breaking up the thread, the energy fizzles out and the discussion dies down. Rather, I've felt this one just keeps moving on into more interesting areas and facets of the placebo concept.

There is so much to be learned, so much is unknown and lots to be discussed.
Maybe I am partly responsible for the erratic course of the thread.
I felt that there is so much that ' placebo' can open us to, as in widen our horizons and change perspective. To this end I am posting a link to an hour long radio program which is a series of interviews with current researchers who are in the forefront of placebo research.
I don't know whether there is a way to get this directly on to the site - I leave that to your expertise - but I would like to emphasize that this is an excellent stepping off point for anyone who would like to challenge their own views on the matter.

http://www.wnyc.org/shows/radiolab/episodes/2007/05/18

Also don't forget that the ONLY physician outside of homeopathic circles that Hahnemann actually considered worthy was Franz Anton Mesmer. A man who could create seizures in susceptible individuals by pointing at them from the next room through a wall.

At the risk of being really trite and pedantic I think Shakespeare had a point:

There are more things in heaven and earth, Horatio,
Than are dreamt of in your philosophy.
FABULOUS! Jonathan, what do you mean by "our" radio show? Is this your show? Are you director/producer/advisor?
Hello,

This is becoming very interesting.

Jonathan, I hope that by rephrasing your question about psychology and biological memory we will sharpen our focus on the issue.

Is placebo always neutral or is it a potential anchor to reignite again and again the similmum-induced-healing-event? Just like a NLP anchor.

Is it the belief-expectation of the patient alone that makes placebo potential? Or, is it the intention of the practitioner that can infuse potency in the placebo?

And, then..

Can a science and art of placebo be developed and legitimately integrated in the healing protocol?

Manoj
Exactly! wow! Incredible discussion.

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