Homeopathy and Placebo

If the above statement is true, they why waste money on giving out fake pills during clinical drug trials? Just having a treatment and no-treatment group would be sufficient, would it not?

This has been suggested, but it's not acceptable for three reasons:

1. The placebo also blinds the evaluators, and reduces the likelihood of outcome bias from a vested interest in the experimentors. Placebo is instrumental in the 'double' part of 'double-blinded'.

2. It prevents the patients from confounding the results. 'Confounding' is just a fancy word for reverse-engineering whether they're in the placebo or drug arm. The reason we want to prevent this is that it eliminates the possibility that a motivated patient will skew results intentionally as a prank, or indirectly by selling the tablets to other patients. (part of my job with placebo design is to analyze results for signs of confounding - there are even ways to confound results if you don't know what group you're in, such as pooling pills among participants)

3. It reduces the opportunity to critique the results. Even if in other experiments it has been demonstrated that the placebo group doesn't usually do any better than the nontreatment group, it could always be argued that "in this case, it could be different." Given the above two reasons, it's nice to have the added bonus of a little more confidence in the credibility of the results.
 
I'll answer this one now (because the information is in a book):

From Psychology: A Student's Handbook by Michael W. Eysenck p.723:



"therapist effect" in Google brings up quite a few pages too.

(For a moment there you had me doubting myself.)

Now that I have context, I see what you mean. Be mindful that Wampold's study is controversial, because he limited it to conditions for which there was already evidence that therapies do not work. Basically studies showing all modalities were equally useless. Specific Axis II complaints.

"Therapist effect" in this context sounds like what I would call baseline recovery rate.

Another problem with these comparative studies is that they often forget to compare to non-treatment (or can't compare to non-treatment, due to ethical concerns), which means they can't rightfully attribute baseline recovery to shared phenomena such as exposure to the clinician.
 
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What benefit?

That depends on the illness and the personality of the patient. Some may feel better simply because something is being done to treat them. Some may have a placebo response. Others may feel better about having someone listen to them while they explain their suffering.

There are different responses to this assumption.

1. The nocebo effect is the creation of negative outcomes from placebo. It is possible for the placebo group to be worse off than the non-experimental and treatment groups.

I think if this was generally the case, homoeopathy (and other non-active treatments) would have long since disappeared.

2. The expense of money for no result means the patient is clearly worse off. They go from being sick to being sick and poorer.

Yes, I'm sure that does happen in some cases. The other outcome is the patient gets better (by them self) and pays for the "care" of a homoeopath.

3. Part of the advocacy of homeopathy is medically disproven advice such as avoidance of conventional treatments and avoidance of prevention. The patient may not even be receiving an homeopathic remedy to be harmed by homeopathy.

Some homoeopaths do this, others do not. I.e. Some homoeopaths consider homoeopathy "complementary", rather than "alternative", to conventional medicine.

4. Adulteration. Many of the worst cases of adulterated naturopathic remedies have been homeopathic. eg: the deceptive addition of significant quantities of viagra to homeopathic remedies. Because they are not monitored by the production controls of prescription medications (such as spot-checking by the FDA for ingredients) homeopathy is disproportionately overrepresented in this problem.

I realise this occurs, but in the context of this discussion it is a distraction. Let's just stick to 'pure' sugar pills, water and ethanol.


I rewind a bit and ask: method of action for what? What outcomes are we 'explaining'?

As I said: I'm unaware of studies that show homeopathy is better than non-treatment.

We're not explaining any outcomes, we're explaining how individuals feel while they are ill. Just as some people find comfort in prayer, it would seem some people get comfort from homoeopathy.

There a plenty of studies showing pain-reducing effects of placebos: E.g.,

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=16120776

Reductions in pain ratings when administered a placebo with expected analgesic properties have been described and hypothesized to be mediated by the pain-suppressive endogenous opioid system. Using molecular imaging techniques, we directly examined the activity of the endogenous opioid system on mu-opioid receptors in humans in sustained pain with and without the administration of a placebo. Significant placebo-induced activation of mu-opioid receptor-mediated neurotransmission was observed in both higher-order and sub-cortical brain regions, which included the pregenual and subgenual rostral anterior cingulate, the dorsolateral prefrontal cortex, the insular cortex, and the nucleus accumbens. Regional activations were paralleled by lower ratings of pain intensity, reductions in its sensory and affective qualities, and in the negative emotional state of the volunteers. These data demonstrate that cognitive factors (e.g., expectation of pain relief) are capable of modulating physical and emotional states through the site-specific activation of mu-opioid receptor signaling in the human brain.

Of course not. I go much longer distances in competition than in training, and don't get interval breaks, so I intentionally go slower. It's called 'strategic pacing', or sometimes just 'pacing'. Same when I did ironman. I don't train 40k runs, but I run 10ks a few times a week. My average speed is certainly faster doing 10ks in training than when running 40k.

Ok, I asked the wrong question.

Are you more motivated while taking part in a competition than training and/or do you put more effort into your training the closer you are to taking part in a competition?
 
I get a rash when I consider a meta-analysis to be more than an indicator.

There are too many variables to consider when you look at studies that are not precisely the same.

I agree. But it indicates that which you seem to be proposing (regression to the mean?).

An experiment would settle matters so we don't even have to talk about a placebo as anything other than a control in testing of other treatments.

Settle matters with whom? If you are talking about those who consider the placebo effect to be a real mind-body effect, I'm not sure that the issue is the lack of sufficient evidence, but rather that people are resistant to giving up their beliefs. It would be interesting to see their reaction to the experiment you suggested, though.

Linda
 
That depends on the illness and the personality of the patient. Some may feel better simply because something is being done to treat them. Some may have a placebo response. Others may feel better about having someone listen to them while they explain their suffering.

How do you measure that? ie: do you have evidence this actually happens?

What conditions have been identified as those that 'work'? Do homeopaths decline treating conditions demonstrated not to 'work'?





I think if this was generally the case, homoeopathy (and other non-active treatments) would have long since disappeared.

That's wishful thinking. The Jeane Dixon Effect applies here, as with many woo subjects. (the willingness to focus on scarce positive results while wilfully ignoring overwhelmingly negative outcomes)

I had a colleague who was using a homeopathic hair restorer. He was constantly telling us about how well it was working. When it became obvious that it wasn't working, he claimed he didn't remember saying it had ever worked. Maybe he believes it, but that's why anecdotes are unacceptable for this type of investigation.





Yes, I'm sure that does happen in some cases. The other outcome is the patient gets better (by them self) and pays for the "care" of a homoeopath.

Hookers are cheaper. And they actually sell what their advertising says they do, which eliminates the 'fraud' element.





Some homoeopaths do this, others do not. I.e. Some homoeopaths consider homoeopathy "complementary", rather than "alternative", to conventional medicine.

I appreciate that, but your claim was that you couldn't understand how homeopathy can be harmful. I don't have any surveys outside of Canada, but a two-year-old survey of NDs who practice homeopathy in BC found that 35% explicitly advise their patients against any form of conventional medicine, including vaccinations.

Of those homeopaths who are not NDs, 68% advise against conventional interventions in general, and 91% agree with the statement, "Vaccines are more likely to harm than benefit the patient," and 83% agreed with the statement, "I advise my patients not to vaccinate their children." 0% agreed with the statement "I advise my patients to vaccinate their children."

It's so prevalent in the profession here, that I would call it a fundamental characteristic. They compare closely to chiropractors in this regard. In a profession where every practitioner appears to have a completely different model of healing (no two homeopaths have prescribed the same nostrum to our standardized patient volunteers), the advice to avoid conventional medicne is pretty much the only constant feature.






I realise this occurs, but in the context of this discussion it is a distraction. Let's just stick to 'pure' sugar pills, water and ethanol.

I don't find it a distraction. It's one of the risks of homeopathy. Most of the big adulteration cases in the US in the last 5 years were homeopathic remedies. (The others were herbal remedies and diet supplements.) They're so disproportionately overrepresented in this category that it deserves attention.





We're not explaining any outcomes, we're explaining how individuals feel while they are ill. Just as some people find comfort in prayer, it would seem some people get comfort from homoeopathy.

That's an outcome: "Do you feel better? yes /no" would be a binary way to record this. There are linear approaches that would be worded like this: "Indicate how well you feel on a scale from one to ten." (compare replies before and after).





I don't see anything in the quoted passage that supports that claim. Here, read this part very closely:
Reductions in pain ratings when administered a placebo with expected analgesic properties have been described and hypothesized to be mediated by the pain-suppressive endogenous opioid system.

"described and hypothesized"... this is not the same as "demonstrated".

The article then goes on to 'explain' something that isn't demonstrated.

Like I said, we get this all the time with quantum explanations for stuff like, for example, remote viewing. It doesn't work, but there is a bucketload of expensive research apparently explaining possible ways it could have. Quantum mechanics, quantum tunneling, teleporation, &c.

Fung Shui's another. There's a huge pile of essays and studies on quantum tunneling to show how it 'works'. I have a lot of trouble finding out what 'works' means, and there are no studies that show anything that looks like evidence that it 'works'.

In any case, there are certainly studies that 'show' pain-relief from placebo, but most have to be discarded as insufficient: unblinded, noncontrolled, &c.

We're left with those 114 from the Cochrane Review, of which about 30 are measuring pain relief outcomes, of which most show no effect, and those that show effect are a mix of placebo (improvement in pain in the placebo group) and nocebo (worsening of pain in the placebo group).





Ok, I asked the wrong question.

Are you more motivated while taking part in a competition than training and/or do you put more effort into your training the closer you are to taking part in a competition?

Motivated? I don't see much difference in motivation, no. Frankly, I don't see the relationship to homeopathy, and I'm very confused by your questions in this direction.
 
Settle matters with whom? If you are talking about those who consider the placebo effect to be a real mind-body effect, I'm not sure that the issue is the lack of sufficient evidence, but rather that people are resistant to giving up their beliefs.

It took me awhile to get to this stage, but especially after the Cochrane Review, I think anybody who claims that there's an actual placebo effect is going to have to explain why they are blatantly rejecting the evidence in the literature that says otherwise.



It would be interesting to see their reaction to the experiment you suggested, though.

I predict they will say that OK: it doesn't work for this type of patient in this one condition. But it works in everything else, and until we've eliminated this infinite list of combinations of patients and conditions, they're free to sell these products and services.
 
I predict they will say that OK: it doesn't work for this type of patient in this one condition. But it works in everything else, and until we've eliminated this infinite list of combinations of patients and conditions, they're free to sell these products and services.

I thought of that as well. I was going to suggest that in this situation, a meta-analysis considering a broad range of outcomes and conditions would actually be more likely to be valid than a single, large, well-done study (for the reason you gave), even though it's usually the other way around.

Linda
 
I thought of that as well. I was going to suggest that in this situation, a meta-analysis considering a broad range of outcomes and conditions would actually be more likely to be valid than a single, large, well-done study (for the reason you gave), even though it's usually the other way around.

Linda

The nice thing about the Cochrane literature review is that it's both a literature review and a meta-analysis, and the two approaches produce the same result.

Even if the reader feels that a meta-analysis is unjustified on the basis that the conditions and metrics are too varied to pool, it still remains that the bulk of the published literature is inadequate and can't be used to make decisions about this topic, and that the valid studies show there is no real evidence of any placebo effect, except a few showing trivial improvement in pain complaints.

Like yourself, I try to mentally ignore the conclusion of a study until the end, because a study's findings often don't support the author's conclusion. Methodology is critical, and most studies can be rejected as inadequate long before getting to the number-crunching stage.

This approach is valid for psi experiments, too - not just clinical trials.

For what it's worth, there are some studies coming out of UBC recently that I'll be reading over the weekend. My prejudice is that there's a prof with an idee fixe who seems to keep doing the same placebo effect experiment over and over again, but he otherwise has a decent reputation.

Basically, he works with parkinson's patients, and claims that he gets results from placebo over nontreatment, and can also invoke a nocebo effect by telling patients the tablets will make them feel worse. He speculates that expectation influences endorphin production, and subsequently influences real symptoms. It's a plausible mechanism, but as with this thread, I'd like to review his papers for actual results before endorsing funding experiments exploring the 'mechanism' of said results.
 
blutoski said:
That depends on the illness and the personality of the patient. Some may feel better simply because something is being done to treat them. Some may have a placebo response. Others may feel better about having someone listen to them while they explain their suffering.

How do you measure that? ie: do you have evidence this actually happens?

Patient satisfaction surveys?

What conditions have been identified as those that 'work'?

I think those conditions where there is a significant subjective component would be amenable to homoeopathy.

Do homeopaths decline treating conditions demonstrated not to 'work'?

No.

I think if this was generally the case, homoeopathy (and other non-active treatments) would have long since disappeared.

That's wishful thinking. The Jeane Dixon Effect applies here, as with many woo subjects. (the willingness to focus on scarce positive results while wilfully ignoring overwhelmingly negative outcomes)

I had a colleague who was using a homeopathic hair restorer. He was constantly telling us about how well it was working. When it became obvious that it wasn't working, he claimed he didn't remember saying it had ever worked. Maybe he believes it, but that's why anecdotes are unacceptable for this type of investigation.

My answer was with respect to the nocebo response to homoeopathy. It doesn’t sound like your colleague had a nocebo response.

Yes, I'm sure that does happen in some cases. The other outcome is the patient gets better (by them self) and pays for the "care" of a homoeopath.

Hookers are cheaper. And they actually sell what their advertising says they do, which eliminates the 'fraud' element.

Yeah, but they don’t care about the individual or their maladies. Are you claiming most homoeopaths are balls-out con artists, knowingly exploiting people?

Some homoeopaths do this, others do not. I.e. Some homoeopaths consider homoeopathy "complementary", rather than "alternative", to conventional medicine.

I appreciate that, but your claim was that you couldn't understand how homeopathy can be harmful. I don't have any surveys outside of Canada, but a two-year-old survey of NDs who practice homeopathy in BC found that 35% explicitly advise their patients against any form of conventional medicine, including vaccinations.

Of those homeopaths who are not NDs, 68% advise against conventional interventions in general, and 91% agree with the statement, "Vaccines are more likely to harm than benefit the patient," and 83% agreed with the statement, "I advise my patients not to vaccinate their children." 0% agreed with the statement "I advise my patients to vaccinate their children."

It's so prevalent in the profession here, that I would call it a fundamental characteristic. They compare closely to chiropractors in this regard. In a profession where every practitioner appears to have a completely different model of healing (no two homeopaths have prescribed the same nostrum to our standardized patient volunteers), the advice to avoid conventional medicne is pretty much the only constant feature.

Let me cut this line of argument short. I’m not interested in the nutty points of view of homoeopaths with regard to vaccination or other conventional treatments in this discussion. The OP is ‘Homoeopathy and Placebo’.

I realise this occurs, but in the context of this discussion it is a distraction. Let's just stick to 'pure' sugar pills, water and ethanol.

I don't find it a distraction. It's one of the risks of homeopathy. Most of the big adulteration cases in the US in the last 5 years were homeopathic remedies. (The others were herbal remedies and diet supplements.) They're so disproportionately overrepresented in this category that it deserves attention.

Yes it does, but not in this thread.

We're not explaining any outcomes, we're explaining how individuals feel while they are ill. Just as some people find comfort in prayer, it would seem some people get comfort from homoeopathy.

That's an outcome: "Do you feel better? yes /no" would be a binary way to record this. There are linear approaches that would be worded like this: "Indicate how well you feel on a scale from one to ten." (compare replies before and after).

http://www.homeopathy-soh.org/whats-new/documents/Positivehomeopathy.pdf

Looking at the patient satisfaction survey results, it appears most people who visit a homoeopath report it has a beneficial effect for them.


I don't see anything in the quoted passage that supports that claim. Here, read this part very closely:
Reductions in pain ratings when administered a placebo with expected analgesic properties have been described and hypothesized to be mediated by the pain-suppressive endogenous opioid system.

"described and hypothesized"... this is not the same as "demonstrated".

The article then goes on to 'explain' something that isn't demonstrated.

Like I said, we get this all the time with quantum explanations for stuff like, for example, remote viewing. It doesn't work, but there is a bucketload of expensive research apparently explaining possible ways it could have. Quantum mechanics, quantum tunneling, teleporation, &c.

Fung Shui's another. There's a huge pile of essays and studies on quantum tunneling to show how it 'works'. I have a lot of trouble finding out what 'works' means, and there are no studies that show anything that looks like evidence that it 'works'.

In any case, there are certainly studies that 'show' pain-relief from placebo, but most have to be discarded as insufficient: unblinded, noncontrolled, &c.

We're left with those 114 from the Cochrane Review, of which about 30 are measuring pain relief outcomes, of which most show no effect, and those that show effect are a mix of placebo (improvement in pain in the placebo group) and nocebo (worsening of pain in the placebo group).

I think you have misread the description. It is the method of action of the placebo effect which is hypothesised, not the pain-suppressive endogenous opioid system. That was the point of doing the experiment – to test the hypothesis that the placebo effect involves an increased activation of the (known) pain-suppressive endogenous opioid system! (It did.)

BTW, the study I linked to does not fall in the woo category and was performed after the Cochrane review. The full-text is free if anyone wants to read the detail of the experiment.

Ok, I asked the wrong question.

Are you more motivated while taking part in a competition than training and/or do you put more effort into your training the closer you are to taking part in a competition?

Motivated? I don't see much difference in motivation, no. Frankly, I don't see the relationship to homeopathy, and I'm very confused by your questions in this direction.

There are sportsmen who are good in training but have improved performance during competition, and those who are good in training but can’t transfer their performance to competition. Clearly the difference is psychological.

Mercutio described how male and female students had to be told to remove their arms from a bucket of icy water when they were competing for bragging rights on whether men or women had the higher pain threshold. He also talks about the effect of hypnosis on the perception of pain.
 
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Patient satisfaction surveys?

So, now homeopathy research is the same as marketing? Will clinical trials be replaced by focus group results next?




I think those conditions where there is a significant subjective component would be amenable to homoeopathy.

'amenable'? My question was actually asking for examples of conditions for which homeopathy has been demonstrated to work better than nontreatment.






My answer was with respect to the nocebo response to homoeopathy. It doesn’t sound like your colleague had a nocebo response.

He didn't. My point was that subjective reports aren't the same as reality, and should not be used to evaluate the value of a health modality.

It *can* be useful in determing if it's a useful product or service, but that doesn't mean it has anything to do with health care.






Yeah, but they don’t care about the individual or their maladies. Are you claiming most homoeopaths are balls-out con artists, knowingly exploiting people?

Having worked with both, I prefer the prostitutes. They are saner, have about the same level of concern for their clients (some are in love with their clients) and the only difference I see is that they're honest about what they're selling.





Let me cut this line of argument short. I’m not interested in the nutty points of view of homoeopaths with regard to vaccination or other conventional treatments in this discussion. The OP is ‘Homoeopathy and Placebo’.

Yes it does, but not in this thread.

I hate thread drift as much as the next guy, but if you felt this way, why did you bring it up? My list of concerns was responding to your claim in this thread that you couldn't understand why anybody would feel homeopathy was unsafe.





http://www.homeopathy-soh.org/whats-new/documents/Positivehomeopathy.pdf

Looking at the patient satisfaction survey results, it appears most people who visit a homoeopath report it has a beneficial effect for them.

Sure. Same with Apple computer users. Doesn't make my iPod a valid health care modality.

There's also the problem, as I mentioned above, of people reporting something that is not actually true. Somebody could be much worse, but report themselves as better.

That's why these get tossed as useless for questions about clinical efficacy.





I think you have misread the description. It is the method of action of the placebo effect which is hypothesised, not the pain-suppressive endogenous opioid system. That was the point of doing the experiment – to test the hypothesis that the placebo effect involves an increased activation of the (known) pain-suppressive endogenous opioid system! (It did.)

BTW, the study I linked to does not fall in the woo category and was performed after the Cochrane review. The full-text is free if anyone wants to read the detail of the experiment.

I don't have to read it: it's trying to explain something (placebo effect) that is undemonstrated. Let's start with showing there's a placebo effect before explaining plausible mechanisms.

1. If there is a demonstrated effect, let's see if it's quantifiably valuable enough to justify pursuing.

2. If it's quantifiably valuable, then I advocate exploration of the mechanism and so on.

3. We're not at that stage yet, and the research actually shows that 1 is limited to pain management, and that 2 is also doubtful, since the effect on pain seems to be so trivial as to possibly be explainable by other means than from actually receiving a placebo.





There are sportsmen who are good in training but have improved performance during competition, and those who are good in training but can’t transfer their performance to competition. Clearly the difference is psychological.

As a coach and competitive athlete, I can say that the last sentence is questionable. Performance does not lend itself to the word 'clearly' in any way, shape, or form. There are simply too many variables.

As an unfortunate consequence of this, sports is rife with pseudoscience, urban legend and outright fraud.
 
I agree. But it indicates that which you seem to be proposing (regression to the mean?)...

Of course I don't doubt the result. An Indicator that indicates that which you already suspected tends not to be doubted. I just would never put it forward as proof of the non-existence of the Placebo Effect. I would, however agree that it clearly shows that there is no proof FOR it.

Some day (in the future where the woo of SciFi is still the best predictor) we will have total simulations of human beings in software; Absolutely accurate models of the physical chemistry of a human down to the last atom. Then, assuming we do not grant such simulations human status, we will be able to resolve questions like these with something like proof. Because I cannot imagine an ethical means of determining this for a non-trivial, non-self-limiting condition. (I'd be happy to hear of one, though!)
 
Ok, I'm reading the Cochrane review and I think we need to settle on a definition of what a 'placebo treatment' is.

With respect to homoeopathy, or conventional medicine for that matter, I consider it the whole interactive experience between the homoeopath or the physician and the patient. In the review the authors explicitly state:

It is a question of definition whether an unbiased comparison between a placebo group and a no-treatment group equals the ’placebo effect’, as this termat times not only implies the effect of a placebo intervention but also various other aspects of the patientprovider interaction, for example psychologically-mediated effects in general, the effect of the patient-provider interaction, the effect of suggestion, the effect of expectancies, and the effect of patients’ experience of meaning (Hróbjartsson 2002b). As patients in the no-treatment group also interact with treatment providers, a notreatment group is only truly untreated when the effect of a placebo intervention is studied (Hróbjartsson 1996). Our result is therefore neutral to many of the meanings of the term ’placebo effect’ cited above. We did not find evidence of an important effect of placebo interventions (or of the patient-provider interaction related to the treatment ritual). However, that does not exclude the possibility of effects of other aspects of the patient-provider interaction (Thomas 1987), though the methodological problems of measuring such effects reliably are demanding (Hróbjartsson 2002b).

I'd also be interested to hear what people who deny the existence of a significant placebo effect make of hypnosis (can someone ask Linda for me - she will answer my questions if someone else asks them:boggled:), particularly with respect to pain reduction or tolerance.
 
Ok, I'm reading the Cochrane review and I think we need to settle on a definition of what a 'placebo treatment' is.

With respect to homoeopathy, or conventional medicine for that matter, I consider it the whole interactive experience between the homoeopath or the physician and the patient. In the review the authors explicitly state:

Yep. And so maybe it's a misunderstanding about terminology. Basically, there are two common uses of the term 'placebo effect'.

Consider this example, treating a condition with two arms:

Placebo Group: 30% improvement
Drug Group: 40% improvement

Some people would call the 30% improvement a "placebo effect" and there are attempts to explain how this can happen: regression to the mean, acclimatization of pain perception, &c. The problem is that there's a missing piece of information. So, here's what the Cochrane study is looking at:

Nontreatment Group: 30% improvement
Placebo Group: 30% improvement
Drug Group: 40% improvement

And they're saying it doesn't look like the placebo actions "do" anything, so why is there an investment in explaining an unobserved phenomenon?

That's another problem with the exit surveys we talked about before: customers 'feeling better' after the visit may not translate into knowing they feel better because of the visit, unless you have an untreated control group with different results. There's also the question of how long the response lasts, and whether this is different than the effects of nontreatment after, say, an hour post-visit. What are customers getting for their money?






I'd also be interested to hear what people who deny the existence of a significant placebo effect make of hypnosis (can someone ask Linda for me - she will answer my questions if someone else asks them:boggled:), particularly with respect to pain reduction or tolerance.

Very open question, as worded. Do you mean, is there anybody who thinks hypnosis 'works'?
 
Good grief.

Homeopathy does have a place

26 Feb 08

I write with reference to the homeopathy debate ('Does homeopathy have any place in general practice?').

I was called out at 3am to treat a man with right-sided quinsy. He was pyrexial, tachycardic, drooling and with such a degree of trismus, lancing his boil was impossible.

While examining him, the homeopathic remedy I had been reading about came to mind - Belladonna, a classic for sudden onset of inflammation with a hot red right cheek, pyrexia, dilated pupils, lachrymation, visible throbbing carotid pulsation and worsening of symptoms after midnight.

I had a homeopathic starter kit to hand so I popped a pill of Belladonna 30c in his mouth.

On returning 10 minutes later to set up a drip and administer his IV cefuroxime and metronidazole, I was somewhat surprised to find him sipping water. His pyrexia and tachycardia had settled.

I sent him home with antibiotics and he didn't need to reattend, although he did have his interval tonsillectomy three months later.

I was amazed and intrigued and have explored integrated medicine since. Belief in homeopathy still escapes my scientific comprehension, and yet patients get better. My partners send their heartsinks to me - these patients seem to stop attending the surgery or do so less often, and I gleefully tick the QOF boxes.

Not proof, nor evidence, but something to think about.

http://www.pulsetoday.co.uk:80/story.asp?sectioncode=39&storycode=4117563&c=2


Could this have been a spectacular placebo response?
 
So what would have happened if the abscess had drained spontaneously?

Would additional problems be expected if the pus went down his throat, rather than into a surgical vacuum cleaner?
 
I once went to surgery because of an abscess. On the very day I was supposed to be cut up, the abscess broke through the skin of itself, and there was really no need to perform the surgery, but the surgeon cut it up anyway in order to "let it drain more efficiently".

This happened without Belladonna.
 
Good grief.

Could this have been a spectacular placebo response?

Spectacular? It sounds like he got into a bit of a panic and felt better once he was able to calm down. Don't be surprised when reassurance and sympathy go a long way toward helping people feel better.

Linda
 
Thanks for that, Linda.

What a pity that the GP doesn’t seem to accept that the Belladonna pill was essentially no more than a prop:
While examining him, the homeopathic remedy I had been reading about came to mind - Belladonna, a classic for sudden onset of inflammation with a hot red right cheek, pyrexia, dilated pupils, lachrymation, visible throbbing carotid pulsation and worsening of symptoms after midnight.

I had a homeopathic starter kit to hand so I popped a pill of Belladonna 30c in his mouth.


It’s so disappointing when GPs/MDs jump to woo-ish conclusions rather than considering more rational explanations.

As yet, there have been no comments posted at Pulse about the article, but hopefully we’ll see some soon (of the sceptical variety).
 
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What a pity that the GP doesn’t seem to accept that the Belladonna pill was essentially no more than a prop:



It’s so disappointing when GPs/MDs jump to woo-ish conclusions rather than considering more rational explanations.

As yet, there have been no comments posted at Pulse about the article, but hopefully we’ll see some soon (of the sceptical variety).


I see it's Andrew Sikorsky, Treasurer of the Faculty of Homeopathy. Odd that his involvement in an organisation with a stated aim of "promoting the availability of homeopathy in the NHS" never seems to get mentioned whenever he pops up promoting the availablity of homoeopathy in the NHS. For example when he was quoted by the BBC in a story about the Tunbridge Wells Homeopathic Hospital he was described merely as "a GP in Tunbridge Wells".
 

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