Forum

Just what is a placebo?

John Ellard

Figures

Abstract

Placebos have demonstrated many powerful effects. Clearly they are not inactive, and like all active substances produce side effects. But how do we define them?

Article Extract

Cognitive dissonance is an uneasy state of mind that arises when one tries to maintain two directly opposed beliefs. I experienced it first-hand about half a century ago, in this way.

I had been to a course in statistics and had learned about the double-blind experimental technique in which the medication under investigation is compared with a substance believed to be inactive – a placebo. Since the placebo given to the control group would do nothing at all, any benefits or harms in the active group would represent the effects of the medication. It was as simple as that – placebos were inactive.

Then it occurred to me that in my outpatients’ duties I was using placebos and achieving very good results. There were virtually no useful psychotropic drugs in those days, and there were sufferers who needed ‘something to take’, rather than more complex psychological help. I made much use of the alkaline mixture of gentian, which I knew could do no harm. I wove a web of comfort and hope around it and many ingested these advantages with the mixture.

Figures