50 Years Ago in CORR: A Clinical Study of 46 Males With Low-Back Disorders Treated with Methocarbamol Andres Grisolia MD and J.E.M. Thomson CORR 1959;13:299–304

Abstract

The double-blind, randomized control trial (in which neither the patient nor the observer knows the treatments, each of which is administered randomly) is considered the gold standard of designs to determine the results of treatment on patients. The concept of a placebo-controlled trial is not new. None other than Benjamin Franklin proposed what is considered the first placebo controlled trial in the 1780s [7], although the experiments were only single-blinded (the subject was unaware of the treatment). Mesmerism, the invention of Anton Mesmer of Austria, was based on the concept that all illness was caused by a blockage of the body’s natural flow and that magnetism (which Mesmer presumed was some sort of ultrafine fluid) restored the flow and health. Mesmer distinguished mineral and animal magnetism, and suggested the latter had curative properties while the former did not. Many of those exposed to his treatments went into trance-like or even sometimes convulsive states. Mesmer was forced out of Vienna as a charlatan, but then enchanted much of Paris. In 1874, King Louis XVI commissioned the Royal Academy of Medicine and the Academy of Sciences to study the matter. The nine commissioners (including Joseph-Ignace Guillotin, who had developed a “humane” method of execution, and Antoine Lavoisier) engaged Benjamin Franklin, who was living at the time as an ambassador of the United States to France, and one of the world’s most famous scientists [3]. At Franklin’s suggestion they devised an experiment in which the subject was blindfolded and unaware of whether they were exposed to any source of magnetism. The Royal Commission concluded, “…only one cause is requisite to one effect, and that since the imagination is sufficient cause, the supposition of the magnetic fluid is useless. In all of these experiments no differences were found other than those due to varying degrees of imagination” [7]. Franklin wrote to an individual seeking his opinion on the matter, “There being so many disorders which cure themselves and such a disposition in mankind to deceive themselves and one another on these occasions…That delusion may however in some cases be of use while it lasts…If these people can be persuaded to forbear their drugs in expectation of being cured…they may possibly find good effects tho’ they mistake the cause” [7].