Magic or sham, the placebo effect has intrigued both doctors and patients for centuries.
Patrick Lemoine is MD, PhD, International Medical Director of the Orpea Clinea group, psychiatry division.
The history of the placebo dates back to 382, with the commissioning of the Vulgate – Latin translation of the Bible. The Vulgate contains the Vespers for the Dead, which begin, “Placebo Domino” (I shall please the Lord). In the 13th century, mourning families would hand out ample food and drink at funerals. This attracted people with little or no relation to the deceased who would sing this verse in the hopes of a meal. They were mockingly named placebos. As society grew more secular, the lord lost its upper case letter and Placebo came to refer to a sycophant, or a flatterer. Later, in the 16th century, a first placebo was used during the Inquisition. To avoid excessive exorcisms, suspects with debatable signs of possession were presented with false, placebo relics. If they reacted as if the relics were authentic, their convulsions were thought to be a figment of their imagination and not from Evil. The idea came about to verify questionable clinical results by administering an ineffectual product.
An example of a pure placebo is the sugar pill. An impure placebo is an available treatment that clearly has not demonstrated its effectiveness, but has a “placebo effect”. This refers to the positive difference between the expected reaction and the observed reaction to a given therapy. If the difference is negative, it is referred to as a nocebo effect (I will harm).
An example of a pure placebo is the sugar pill. An impure placebo is an available treatment that clearly has not demonstrated its effectiveness, but has a “placebo effect”.
The placebo effect concerns all specialities. According to medical authors like Henry K. Beecher, placebos work an average of one-third of the time. In treating angina pectoris, they can be effective in up to 85% of cases. Placebos can also work in treating infection, hypertension or insomnia.
Of all the explanations provided, psychoneuroimmunology has provided the most biological insight. An example: rats are anaesthetised, and an incision is made in the skin on their head using a dirty lancet. A visible bandage is applied to the wound before they are awoken. A few days later, leukocytes develop to fight the infection. The entire operation is repeated two more times, but the fourth time, there is no incision, just the bandage. The number of white blood cells increases as if the infectious operation had taken place. The conclusion? A false external stimulus can even cause white blood cells to react.
In fact, placebos seem to act by encouraging the organism to produce its own endogenous medicines, such as endorphins for pain, dopamine for Parkinson’s disease, serotonin for depression and probably natural antibiotics for infection. Our body can actually develop any drug in the world – and even better than the pharmaceutical industry – because it will produce anything to protect itself and survive.