Placebo in history
The word placebo was used in a medicinal context in the late 18th century to describe a "commonplace method or medicine" and in 1811 it was defined as "any medicine adapted more to please than to benefit the patient". Although this definition contained a derogatory implication,[1] it did not necessarily imply that the remedy had no effect.[2]
Placebos have featured in medical use until well into the twentieth century.[3] In 1955 Henry K. Beecher published an influential paper entitled The Powerful Placebo which proposed idea that placebo effects were clinically important.[4] Subsequent re-analysis of his materials, however, found in them no evidence of any "placebo effect".[5]
Etymology
Placebo is the opening word of the
Early medical usage
In the practice of medicine it had been long understood that, as Ambroise Paré (1510–1590) had expressed it, the physician's duty was to "cure occasionally, relieve often, console always" ("Guérir quelquefois, soulager souvent, consoler toujours"). Accordingly, placebos were widespread in medicine until the 20th century, and were often endorsed as necessary deceptions.[3]
According to Nicholas Jewson, eighteenth century English medicine was gradually moving away from a model in which the patient had considerable interaction with the physician – and, through this consultative relationship, had an equal influence on the physician's therapeutic approach. It was moving towards a paradigm in which the patient became the recipient of a more standardized form of intervention that was determined by the prevailing opinions of the medical profession of the day.[8]
Jewson characterized this as parallel to the changes that were taking place in the manner in which medical knowledge was being produced; namely, a transition from "bedside medicine", through to "hospital medicine", and finally to "laboratory medicine".[9]
The last vestiges of the "consoling" approach to treatment were the prescription of morale-boosting and pleasing remedies, such as the "
In 1811, Hooper's Quincy's Lexicon–Medicum defined placebo as "an epithet given to any medicine adapted more to please than benefit the patient".
Early implementations of placebo controls date back to 16th-century Europe with Catholic efforts to discredit exorcisms. Individuals who claimed to be possessed by demonic forces were given false holy objects. If the person reacted with violent contortions, it was concluded that the possession was purely imagination.[10]
Use of the placebo effect as a medical treatment has been controversial throughout history, and was common until the mid twentieth century.[3] In 1903 Richard Cabot concluded that it should be avoided because it is deceptive. Newman points out the "placebo paradox" – it may be unethical to use a placebo, but also unethical "not to use something that heals". He suggests to solve this dilemma by appropriating the meaning response in medicine, that is make use of the placebo effect, as long as the "one administering... is honest, open, and believes in its potential healing power".[11]
Émile Coué, a French pharmacist, working as an apothecary at Troyes between 1882 and 1910, also advocated the effectiveness of the "Placebo Effect". He became known for reassuring his clients by praising each remedy's efficiency and leaving a small positive notice with each given medication. His book Self-Mastery Through Conscious Autosuggestion was published in England (1920) and in the United States (1922).
Placebos remained widespread in medicine until the 20th century, and they were sometimes endorsed as necessary deceptions.[3] In 1903, Richard Cabot said that he was brought up to use placebos,[3] but he ultimately concluded by saying that "I have not yet found any case in which a lie does not do more harm than good".[11]
T. C. Graves first defined the "placebo effect" in a published paper in The Lancet in 1920.[original research?][14] He spoke of "the placebo effects of drugs" being manifested in those cases where "a real psychotherapeutic effect appears to have been produced".[15]
Placebo effect
The placebo effect of new drugs was known anecdotally in the 18th century, as demonstrated by Michel-Philippe Bouvart's 1780s quip to a patient that she should "take [a remedy] ... and hurry up while it [still] cures."[16] A similar sentiment was expressed by William Heberden in 1803[17] and Armand Trousseau in 1833.[18] It is often attributed to William Osler (1901) but without a precise source, and it does not appear in his publications.[19][20]
The first to recognize and demonstrate the placebo effect was English physician
The wooden pointers were just as useful as the expensive metal ones, showing "to a degree which has never been suspected, what powerful influence upon diseases is produced by mere imagination".[23] While the word placebo had been used since 1772, this is the first real demonstration of the placebo effect.[citation needed]
In modern times the first to define and discuss the "placebo effect" was T.C. Graves, in a 1920 paper in The Lancet.[24] He spoke of "the placebo effects of drugs" being manifested in those cases where "a real psychotherapeutic effect appears to have been produced".[25]
At the Royal London Hospital in 1933, William Evans and Clifford Hoyle experimented with 90 subjects and published studies which compared the outcomes from the administration of an active drug and a dummy simulator ("placebo") in the same trial. The experiment displayed no significant difference between drug treatment and placebo treatment, leading the researchers to conclude that the drug exerted no specific effects in relation to the conditions being treated. [26] A similar experiment was carried out by Harry Gold, Nathaniel Kwit and Harold Otto in 1937, with the use of 700 subjects.[27]
In 1946, the
In 1955, Henry K. Beecher published a paper entitled The Powerful Placebo. Since that time, 40 years ago, the placebo effect has been considered a scientific fact. Beecher was the first scientist to quantify the placebo effect. [...] This publication is still the most frequently cited placebo reference. Recently Beecher’s article was reanalyzed with surprising results: In contrast to his claim, no evidence was found of any placebo effect in any of the studies cited by him.
— Kienle & Kiene, The Powerful Placebo Effect: Fact or Fiction? [5]
In 1961 Henry K. Beecher concluded[31] that surgeons he categorized as enthusiasts relieved their patients' chest pain and heart problems more than skeptic surgeons.[11]
In 1961 Walter Kennedy introduced the word nocebo to refer to a neutral substance that creates harmful effects in a patient who takes it.[3][32]
Beginning in the 1960s, the placebo effect became widely recognized and placebo-controlled trials became the norm in the approval of new medications.[33]
A 2001
Placebo observations differ between individuals.[36][37] In the 1950s, there was considerable research to find whether there was a specific personality to those that responded to placebos. The findings could not be replicated[38] and it is now thought to have no effect.[39]
The word obecalp, "placebo" spelled backwards, was coined by an Australian doctor in 1998 when he recognised the need for a freely available placebo.[40] The word is sometimes used to make the use or prescription of fake medicine less obvious to the patient.[41]
It has been suggested that a distinction exists between the placebo effect (which applies to a group) and the placebo response (which is individual).[42]
See also
References
- ^ S2CID 2733947.
- S2CID 34023318.
- ^ PMID 10692902.
- ^ PMID 11372012.
- ^ PMID 9449934.
- ^ Psalms 116:9
- PMID 10844895.
- S2CID 143768672.
- S2CID 144097257.
- ISBN 978-0-06-207156-9.
- ^ ISBN 978-1-4165-5153-9.
- S2CID 208293370.
- ^ Haygarth J (1800). "Of the Imagination, as a Cause and as a Cure of Disorders of the Body; Exemplified by Fictitious Tractors, and Epidemical Convulsions". Bath: Crutwell. Archived from the original on December 15, 2013.
- . Retrieved January 2, 2014.
- ISBN 978-0-415-88494-5.
- ^ Gaston de Lévis, Souvenirs et portraits, 1780-1789, 1813, p. 240
- ^ William Heberden, Commentaries on the History and Cure of Diseases, London, 1802, p. 40
- ^ Armand Trousseau, Dictionnaire de Médecine, 1833 (page unspecified), as quoted in H. Bernheim, Suggestive Therapeutics, 1889 (page unspecified), quoted in "Competitive Probems in the Drug Industry", U.S. Senate hearings, 1968, p. 3008.
- ^ Charles Murphy, "Guest blog", Emergency Medical Journal, March 30, 2014
- ^ Donald L. Blanchard, Daniel M. Albert, "Historical Excerpts and Quotations Corner", American Academy of Ophthalmology, May 9, 2018
- S2CID 208293370.
- ^ Haygarth, J., Of the Imagination, as a Cause and as a Cure of Disorders of the Body; Exemplified by Fictitious Tractors, and Epidemical Convulsions Archived December 15, 2013, at the Wayback Machine, Crutwell, (Bath), 1800.
- ^ Wootton, David. Bad medicine: Doctors doing harm since Hippocrates. Oxford University Press, 2006.
- . Retrieved January 2, 2014.
- ISBN 9780415884945.
- ^ Evans W, Hoyle C (1933). "The comparative value of drugs used in the continuous treatment of angina pectoris". Quarterly Journal of Medicine. Archived from the original on January 2, 2014. Retrieved January 2, 2014.
- doi:10.1001/jama.1937.02780260001001. Archived from the originalon May 19, 2011. Retrieved January 2, 2014.
- ^ Jellinek, E. M. "Clinical Tests on Comparative Effectiveness of Analgesic Drugs", Biometrics Bulletin, Vol.2, No.5, (October 1946), pp. 87–91.
- S2CID 3173505.
- PMID 20171404.
- PMID 13688614.
- ^ Kennedy, W. P., "The Nocebo Reaction", Medical World, Vol.95, (September 1961), pp. 203–5.
- S2CID 10931827.
- ISBN 978-0-00-712612-5.
- PMID 20091554.
- S2CID 37893726.
- PMID 291020.
- PMID 364041.
- S2CID 1037796.
- ^ Axtens, Michael (August 8, 1998). "Letters to editor: Mind Games". New Scientist.
- ^ E.g. see Gulf War Veteran Gets Placebos Instead Of Real Medicine Archived February 4, 2009, at the Wayback Machine or BehindTheMedspeak: Obecalp.
- S2CID 1037796.