By James Harvey Stout (deceased). This material is now in the public domain. The complete collection of Mr. Stout's writing is now at http://stout.mybravenet.com/public_html/h/ >
Jump to the following topics:
What is a placebo? It is a substance or procedure which has no medical function but which is given to a patient whose belief in its value can cause an improvement in his or her condition. We usually think of a placebo as a "sugar pill" (a pharmacologically inert substance), but the term can also apply to any medically unnecessary routine which is performed for its psychological or psychophysiological effect; this can include salt-water injections, vitamins, X-rays, various types of therapies, and even surgery.
Placebos are used frequently. The placebo phenomenon is recognized by medical journals and by the U.S. Food and Drug Administration. Placebos are used in the testing of new medicines, with one group of people receiving a placebo, and another group receiving the actual drug, to verify that the drug is more effective than a placebo. An estimated 35 to 45 percent of all prescriptions are for placebos; generally, doctors prescribe them because patients insist, for example, "Give me something for my cold". (We might wonder how many billions of dollars consumers waste each year on placebo prescriptions because of that unreasonable demand.) Until modern times, when many effective drugs became available, doctors relied more heavily on placebos because there was only a small selection of actual drugs.
How does a placebo work? The placebo effect starts in the mind. As a result of confidence in the placebo and in the doctor, the patient generates an expectation that a cure will transpire. The body generates various responses, including the release of endorphins (which counteract pain), and an increase in the white blood cell count. Researchers have speculated that placebos might also trigger the body's release of interferon (to combat infection) and steroids (to diminish inflammation).
Placebos can be effective. Approximately one-third of the people who use placebos experience an improvement in their condition. Placebos are useful in virtually all diseases and ailments which can be alleviated by the body's innate healing functions (and thus can be stimulated by the placebo effect); this includes colds, ulcers, hay fever, high blood pressure, headaches, arthritis, insomnia, morphine withdrawal, and post-operative pain.
Can we generate "the placebo effect" without placebos? It is the body's own resources (and our faith) which cause the healing, so placebos might seem to be unnecessary. But placebos give us an extra reason to believe: we are dealing with a physical ailment, so we might feel that we need a physical substance in order to produce a cure. Particularly in a society which has a great regard for science, technology, and materiality, we are more assured by a pill than we would be by a quasi-mystical "faith healing", although it is our faith which grants effectiveness to the placebo. When we understand more about the placebo effect, and the ways in which the psyche can regain and maintain physical health, perhaps we will no longer need sugar pills.
