The placebo effect

Abstract

Historically the term placebo harks back to the 116th psalm in the Hebrew bible. The ninth verse of this psalm begins with the word “et-ha-lech” (I shall walk), which was strangely translated into the Septuagint Greek as “euarestiso” and then into its Vulgate Latin equivalent of “placebo,” the first-person singular future tense of the verb meaning to please. In the twelfth century the word entered the English language as the name commonly given to the vespers for the dead. A few centuries later, placebo began to take on secular meanings, almost all of them derisive. For example, it was used to denote a servile flatterer and toady, and professional mourners were hired to “sing placebos“ at the bier of the deceased, as substitutes for members of the family. In medicine the first definition appeared in 1785 in Motherby’s New Medicul Dictionary as “a commonplace method or medicine.” By the 1795 edition the description had been expanded to include the words “calculated to amuse for a time, rather than for any other purpose.” The next dictionary change added the implication that the placebo was both inert and harmless. a “make-believe medicine,” devoid of effect. While the word placebo has for a long time been associated in the minds of physicians with deception or pandering to the desires of misguided and neurotic patients, for centuries most of the therapies in vogue were actually placebos, pharmacologic ciphers helpful primarily because of the mystique surrounding their use. Unicorn’s horn; bezoar “stone” from animal stomachs; the mish-mash known as theriac, with its principal ingredient of viper flesh; moss from the skull of a hanged criminal; eunuch fat; dried mummythese were at best inadvertently fraudulent remedies, for all their popularity. Even in the eighteenth and nineteenth centuries much of what the medical profession did in the way of therapy depended on the credulity of both doctor and patient and on the healing powers of time. For example, there was little reason for rejoicing around the turn of the nineteenth century over the attempts