A new study of homeopathic arnica suggests efficacy. How come?

Subjects scheduled for rhinoplasty surgery with nasal bone osteotomies by a single surgeon were prospectively randomized to receive either oral perioperative arnica or placebo in a double-blinded fashion. A commercially available preparation was used which contained 12 capsules: one 500 mg capsule with arnica 1M is given preoperatively on the morning of surgery and two more later that day after surgery. Thereafter, arnica was administered in the 12C potency three times daily for the next 3 days (“C” indicates a 100-fold serial dilution; and M, a 1000-fold dilution)

Ecchymosis was measured in digital “three-quarter”-view photographs at three postoperative time points. Each bruise was outlined with Adobe Photoshop and the extent was scaled to a standardized reference card. Cyan, magenta, yellow, black, and luminosity were analyzed in the bruised and control areas to calculate change in intensity.

Compared with 13 subjects receiving placebo, 9 taking arnica had 16.2%, 32.9%, and 20.4% less extent on postoperative days 2/3, 7, and 9/10, a statistically significant difference on day 7. Color change initially showed 13.1% increase in intensity with arnica, but 10.9% and 36.3% decreases on days 7 and 9/10, a statistically significant difference on day 9/10. One subject experienced mild itching and rash with the study drug that resolved during the study period.

The authors concluded that Arnica montana seems to accelerate postoperative healing, with quicker resolution of the extent and the intensity of ecchymosis after osteotomies in rhinoplasty surgery, which may dramatically affect patient satisfaction.

Why are the results positive? Pervious systematic reviews confirm that homeopathic arnica is a pure placebo. First, I thought the answer lies in the 1M potency. It could well still contain active molecules. But then I realised that the answer is much more simple: if we apply the conventional level of statistical significance, there are no statistically significant differences to placebo at all! I had not noticed the little sentence by the authors: a P value of 0.1 was set as a meaningful difference with statistical significance. In fact, none of the effects called significant by the authors pass the conventionally used probability level of 5%.

So, what so the results of this new study truly mean? In my view, they show what was known all along: HOMEOPATHIC REMEDIES ARE PLACEBOS.

18 Responses to Homeopathic arnica works! One only needs to change the definitions

  • All you need is the right amount of confirmation bias and that “minor” detail just disappears. After that one can just add the paper to the ever growing pile of poor studies showing that homeopathy “works”. That is probably the point of doing these studies in the first place.

  • I cannot acess the full paper but note:
    “Subjects scheduled for rhinoplasty surgery with nasal bone osteotomies by a single surgeon were prospectively randomized to receive either oral perioperative A. montana or placebo in a double-blinded fashion.”

    Subjects were randomised to receive a ‘real’ remedy or placebo. Good.
    But what does “…in a double-blinded fashion” mean?
    Presumably, that neither the surgeon nor patient knew which group they were in at the time of surgery, but the abstract goes on to say:
    “Ecchymosis was measured…”
    Now, when was the blind removed?
    After surgery obviously, but before or after the post-op assessments were made?

    I am being pedantic, but such is necessary if we are not to be misled – I am unclear on this point and if the assessor knew the grouping at time of assessment, confirmation bias is likely.

    Does the original paper make this point clear?
    Or are my concerns properly addressed by the phrase “…in a double-blind fashion”?

    • it remains unclear also in the full text

      • Ah ha!

        Can you ask them to clarify, or do we assume that as they have rather unusually taken p to equal 0.1 (as they are entitled to, but should have drawn more attention to this unusual probability) – we might reasonably suspect subterfuge?

  • Yeh, well, we all know that the more diluted a P value is, the more potent it becomes.

  • Isn’t that a rather small sample size, anyway? It’s a horribly long time since my stats degree, but I remember a lecturer emphasising how a small sample is pretty hopeless by making us recalculate (with just lumpy calculators, no computers!) with just one more/less positive outcome observed. There’s just no way to get robust results when one person is 4.5% of the total, surely?

  • It is easy to say that a product is a placebo but do we really take the basic principles of science into consideration. To heal a wound what is essential is blood flow. How do we get blood flow? To my mind a golden rule not applied by the medical fraternity is to take the pH of the body fluids into account. The ph of the body fluids (Variable)must be equal to the pH of the blood (not Variable) then the red blood cell’s will go into suspension and blood flow will be maximized. This is basic colloidal science and is not taught in medical school. Further if you want to apply any cream whether it is arnica oil combination together with high pH diluted water or any other product one must make sure that the pH value of the product equals the pH of the blood. And remember different blood groups have different pH values. So next time when a medical trial is conducted look at the facts and then you might experience why a “placebo” works. No offense I am not a homeopath or a Doctor and look at the matter impartially with I hope common sense. Look at the learnings of Dr. T C Mcdaniel (Google)and I think great advances in the medical field will emerge.

    • As a child of seven I knew that blood IS a ‘body fluid’.
      pH varies in all tisues by the splittest of seconds. (The process is called tissue respiration).
      There is no ‘pH’ save as an indicator of the value at a paticullar moment and as measured.

      “Dr. TC McDaniel teaches us how diseases can be prevented and Zestful Wellness achieved through the principals of Zeta Potential…Zeta Potential is a measure of the electrical force that exists between atoms, molecules, particles, suspensoids, cells, etc,.. in a fluid (colloidal suspension).
      Zeta potenial’s strength determines the amount of material (nutrients, wastes) that fluids such as your blood and lymph can carry. Increasing the electrical force in the solution allows the fluid to dissolve and hold more material. In this way, more nutrients can be carried throughout your body and accumulated deposits of waste can be removed.”

      Pieter, as I am sure you know perfectly well, there is no plausible evidence for the validity of these propositions, and by any standards McDaniel has to be regarded as a quack (boasting about unsubstantiated practices).
      Or did you not realise that?

      • Richard thanks for your comments. You seem to understand Zestful Wellness through Zeta Potential very well, surely it should carry weight and could be beneficial to patients,10 000 mentioned, successfully treated. He is also a well decorated and respected person, My nature is to respect people for there is hopefully something good in everyone. Again no offense.

        • Different blood groups have different pH?! Er, source?

          • Google or Yahoo pH value for different blood groups, information gathered B=6.8, AB=7 and O and A =7.4 can vary for different populations.

          • pH varies by the pico second. In all tissues.
            When we measure ‘pH’ we are taking an average – and if the detailed science is critical, will have to consider a range and probabilities.
            When I assisted with renal transplantation, a simple figure was good enough.
            It depends on what you use the measurement for as to how accurate you want it to be – and to how many decimal places!

            This thread started with Pieter’s assertion on 15th May that blood ph is ‘not variable’. Nuff said.

          • This is of course nonsense, and serve well as an illustration of how seriously to take you.
            I’m sure doctors and hospitals would be ecstatic if it were the case, mind you. No need for all that time-wasting blood typing palaver, just stick a standard cheap pH test strip in!

          • Hi Vyv, You are entitled to your opinion, suppose all the information on google should not be taken seriously.
            I still maintain that pH of body fluids are variable and the pH of blood is fixed. Bless you.

          • this is not a question of opinion!

          • This is particularly true in unicorns.
            Scientists have prooved it.
            By research.

          • @ pieter hj labuschagne,
            Are you the person who works at the University of Pretoria and who is a noted god-botherer?

            My question for you is; what becomes of the different pH levels when blood enters the organs and, subsequently, returns from the organs?

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