Steele (1891, pp. 277–8): “To argue with a man, and especially with a woman, that there is little the matter with them might be thought injudicious, and to advise them to return at a more convenient occasion requires more time and resolution than writing out a prescription or administering a placebo.”

“PLACEBO EFFECT”

The placebo effect, mind over matter, usually used in relation to the medical field, is the basis for this story of a hypochondriac who comes into the hospital with a bleeding finger and a nervous twitch. An intriguing look into what the mind can truly accomplish, this episode is one that redeems the 42-episode long series.

Pepper (1945, p. 411): “There may be a time when during the carrying out of diagnostic tests it is undesirable to give potent medicine lest it interfere with the tests and yet the patient must be encouraged by treatment…. There is a certain amount of skill in the choice and administration of a placebo. In the first place, it must be nothing more than what the name implies a medicine without any pharmacologic action whatever. Even a mild sedative is not a true placebo. Secondly, its name must be unknown to even the most inveterate patient who knows most drugs by name and is always quick to read the prescription. If the medicines named are familiar, the type of patient who needs a placebo will promptly exclaim that this or that drug had been tried and ‘had not helped me’ or ‘had upset my stomach’. It is well if the drug have a Latin and polysyllabic name; it is wise if it be prescribed with some assurance and emphasis for psychotherapeutic effect. The older physicians each had his favorite placeboic prescriptions – one chose Tincture of Condurango, another the Fluidextract [sic] of Cimicifuga nigra. Certainly this latter by its Latin name might be expected to have more supratentorial action than if one merely wrote for the Black Cohosh, and Condurango would be more effectual than sugar of milk.” Pepper’s assertion that a placebo “must be nothing more than what the name implies” – namely that it must be “a medicine without any pharmacologic action whatever” – in order for it to be called a placebo, is most significant.

Cochrane^[39] “It is important to distinguish the very respectable, conscious use of placebos. The effect of placebos has been shown by randomised controlled trials to be very large. Their use in the correct place is to be encouraged. What is inefficient is the use of relatively expensive drugs as placebos.”

Served in Iraq and Afghanistan in the Army Medical Services Reserves and is a Florence Nightingale Leadership Scholar