Homoeopathic Society

Vol. 19 No. 1 February 1999

by Bruce Barwell

A recent study of all the trials to determine the effects, if any, of Arnica montana has concluded that no effect has been detected yet. The report was published in the Archives of Surgery, November 1998, and was based on eight trials that had met standards for inclusion. The authors, Ernst and Pittler, from the Department of Complementary Medicine at the University of Exeter, had this to say: “On balance the studies do not suggest that homœopathic Arnica is more efficacious than placebo.”

This conclusion is not surprising because all the trials of Arnica that I have read in mainstream medical literature found little to support homœopaths’ enthusiasm for the remedy.

Here is a summary of the abstracts of some of the trials Ernst and Pittler will have scrutinised:

• Double-blind, placebo-controlled, randomised clinical trial of homœopathic Arnica 30c for pain and infection after total abdominal hysterectomy; Journal of the Royal Society of Medicine, February 1997. “We conclude that Arnica in homœopathic potency had no effect on postoperative recovery in the context of our study . . . 35 received placebo and 38 received Arnica 30c.”

• Metronidazole (Flagyl) and Arnica montana in the prevention of post-surgical complications, a comparative, placebo-controlled trial; British Journal of Oral and Maxillofacial Surgery, February 1984. “Metronidazole was more effective in pain control than Arnica and placebo, and was more effective in promoting healing than Arnica and placebo. Arnica appeared to give rise to greater pain . . . and caused more swelling than placebo. (118 people had impacted wisdom teeth removed, 41 had metronidazole, 39 Arnica, 38 placebo.)

• Les effets de l’Arnica montana sur la coagulation sanguine. Essai clinique randomise; Canadian Family Physician, November 1993, and erratum February 1994. “It was shown that this substance had no significant impact on various parameters of blood coagulation in healthy volunteers . . .”

• Effect of Arnica 30x during hard physical exertion (original in Norwegian); Tidsskrift For Den Norske Laegeforening, 10 December 1990. Some runners in the Oslo Marathon of 1990 got Arnica for five days starting the day before the race. Blood and more subjective things were tested before the race, at the finish, and after 48 and 72 hours. “A feeling of stiffness was more pronounced in the placebo group . . . . There was no indication that Arnica reduced the time of restitution (return to normal).”

How can this be? My feeling is that the effectiveness of Arnica is far more dependent on both the nature of the condition for which it has been prescribed and the potency employed than is commonly believed.

One of the few trials, maybe even the only trial, to show the importance of potency choice used Arnica. It was reported in the British Homœopathic Journal of July 1976.

The experiment involved people taking varying potencies of Arnica while a device like a miniature guillotine dropped a weight (rather than a blade!) on the subject’s forearm.

Two trials were carried out, using staff at the Royal London Homœopathic Hospital, students at the Missionary School of Medicine, and participants at an intensive course at the hospital.

In the trial of Arnica 30c the subjects received either the Arnica or placebo; they took one tablet before being bruised, one 4 hours later, one at bedtime, and two the next day. This procedure was repeated about a week later

One person had a smaller bruise after Arnica 30c, two had a smaller bruise after placebo.

The Arnica 10M trial involved two bruising episodes 3 days apart; everyone got placebo the first time.

Six people had a smaller bruise after Arnica; three of these had a bruise after placebo but none after Arnica. For seven people there was little difference in size of bruise after placebo or Arnica 10M.

In summary, then, in a 10-person trial of Arnica 30c placebo did better than Arnica. In a trial of Arnica 10M involving 13 people 7 showed next-to-no benefit from taking Arnica.

In response to a critical letter printed in the BHJ of January 1997 the supervisor of the trials, Dr Anthony Campbell, agreed that it was not true homœopathy to prescribe before medication was required, and the Arnica may have worked better if not given in anticipation. Also he expressed regret that the 10M potency had been made using a Korsakov (one-bottle-method) machine, and so its true “strength” was a guess. Many homœopaths believe a hand-made 200¬bottle 200c to be vastly more powerful than even a machine made 50M.

One of the good homœopaths I met in Kerala when I was in India in 1972-73 was Dr T P Elias. In a paper published in the Transactions of the International Homœopathic Congress 1967 Elias reports on experiments he had done when studying in Münster, Germany, observing the effect on clotting time, etc, of arsenic and Arnica on blood in a test apparatus called a thromb-elastograph.

He observed that the 6c potency Arsenicum album stopped reducing the elasticity of the clot; higher potencies had the effect of increasing the elasticity of the clot-of the potencies tested it seemed that Arsenicum was at its maximum of creating clot elasticity at 8c.

Elias tested Arnica also, but not so thoroughly.

Using Arsenicum 2x and a de-alcoholed Arnica tincture these results were obtained:

[Figures show time to coagulation or recalcification in seconds.]

The results show how Arnica has scant effect at the strength used in the trial.

Further work using homœopathic preparations of different potency on blood in vitro is needed, and could discover therapeutically useful facts. This is obviously more “scientific” than trying to bruise trainee missionaries, amusing as this may be to some people.

The arnica plant has received a lot of attention from people who analyse the chemicals of plants looking for therapeutic agents or to help classify species.

The centre for this study is the Institute for Pharmaceutical Biology at Heinrich Heine University in Düsseldorf, Germany. A research report from there says there are about 30 species of Arnica worldwide, many of them used medicinally. The chief active substances of interest are sesquiterpenlactones and flavonoids. At least 73 substances have been isolated from Arnica plants.

Sesquiterpenlactones have anticancer properties. Other chemicals in Arnica are helanin, which has been demonstrated among other things to be antibiotic, anti-inflammatory, antitumour and immuno¬stimulant (it contains more helanin than any other plant, Euphatorium perfoliatum ranking next); dihydrohelanin, an antibacterial; arnidiol, a counter-irritant (sunflowers are second for arnidiol content); angelic acid, a sedative; arnicolide, an antiallergen; chlorogenic acid, caffeic acid, gallic acid and luteolin are antiviral; and astragalin, an anti¬leukæmic; and so on. One chemical is a bruchiphobe. What is a bruchiphobe? Answer next issue.

So, there is no reason to think Arnica is inherently light in therapeutic potential.

The problem is, as stated earlier, it has come to be regarded as the universal, one-remedy-fits-all trauma remedy.

I was not happy to hear, as some homœopaths were, that most Playcentres have Arnica on hand and use it liberally. A safer, and more appropriate, remedy is Ferrum phosphoricum if administered promptly.

Arnica is not a shock remedy, despite at least one pharmacy’s frequently advertised claim, with the exception of blood-loss shock. Aconitum and Veratum album are the leading shock remedies.

Arnica in most situations acts as an anticoagulant; it will be okay to give it to 95% of people as soon as they show signs of having a stroke, but if the symptoms arise from a ruptured blood vessel in the brain Arnica may very well kill them.

For the same reason only qualified prescribers should give it to people with easy bruising from a hæmorrhagic disorder, even a mild type.

Arnica is not always useful, not always safe, and potency choice is important. There is a need for more people to know about the remedies that may be more appropriate than Arnica.