In the paper entitled [A Study of the Placebo Response](https://www.amjmed.com/article/0002-9343(54)90441-6/abstract) Beecher et al. looked at a group of 162 post-operative patients and evaluated treatment of post-operative pain (analgesics versus placebo). The authors found no sex difference and no difference in intelligence between patients showed the “placebo effect” versus those that didn’t. The word *placebo* comes from the Latin for “I will please” and can be dated back to a Latin translation of the Bible by St. Jerome - for instance, Psalm 116:9 — *“placebo Domino in regione vivorum”* (“I will please the Lord in the land of the living”). An 1811 medical dictionary defined placebo as “an epithet given to any medicine adapted more to please than to benefit the patient.” [Here is a recent study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572011/) that looks at the association between ulcer diseases and mental health problems such as stress. The authors concluded that: > Psychological problems, such as severe stress, depressed mood, suicidal ideation, and psychological counseling, were associated with peptic ulcer disease prevalence. **Henry K. Beecher** (1904 – 1976) was a professor of anesthesiology at Harvard Medical School. Beecher earned an A.M. degree in 1927 in physical chemistry from University of Kansas. His goal was to earn a Ph.D. in chemistry at the Paris-Sorbonne University but was persuaded to study medicine instead. His investigation of the placebo effect was inspired by his experiences during World War II. He wrote: > Three-quarters of badly wounded men, although they have received no morphine for hours... have so little pain that they do not want pain relief medication, even though the questions raised remind them that such is available for the asking. This is a puzzling thing and perhaps justifies a little speculation.  *Henry K. Beecher* Beecher was one of the first researchers to recognize the importance of double-blind placebo-controlled clinical trials (in which neither subject nor doctor know whether the subject will receive a drug or a placebo) when evaluating drugs. Within a few years this would become the new standard when evaluating drugs. In 1962, when the Food and Drug Administration began to require pharmaceutical companies to prove their new drugs were effective before they came to market, they turned to the new method. It’s important to note that even tho this publication remains one of the most cited references on placebo treatments, subsequent reviews of Beecher’s work have challenged his conclusions. A 1997 study entitled [*The Powerful Placebo Effect: Fact or Fiction?*](https://www.ncbi.nlm.nih.gov/pubmed/9449934) claims that the studies cited by Beecher lack convincing evidence of the placebo effect. Here are a few points made by authors: - *Spontaneous Improvement* - In some situations just because a patient gets better after a few days of placebo treatment one cannot necessarily conclude that the recovery was the result of the placebo. In a placebo-controlled drug trial on acute common cold, described as mild and of short duration, 35% of the patients felt better within 6 days. Beecher interpreted these improvements as an effect of the placebo administration, whereas it could be simply because many patients with a common cold improve spontaneously within a few days. - *Fluctuation of Symptoms* - In chronic diseases fluctuation of symptoms should be taken into account. Patients feel better one day and worse the next. Therefore, looking at a number of chronically ill patients, one will simply always see some patients improving. - *Additional Treatment* - So-called placebo effects sometimes occur under some additional treatment, which can put into question weather one can call such improvements a "placebo effect". In one of the angina pectoris trials in Beecher’s list the placebo group additionally received nitrates. In another trial, concerning the common cold, the patients were allowed to take rest, hot baths, gargles, diets, etc. ## First placebo controlled trial One of the first documented placebo controlled trials took place in late-eighteenth-century France at the request of King Louis XVI. The subject of this study was *mesmerism* - a new treatment invented by German physician Franz Anton Mesmer (whose last name is the origin of the word *mesmerize*) in which the “cure" for all sorts of ailments was reportedly achieved by harnessing a magnetic fluid that connected all living things. Mesmer treatments would often involve having patients take seats around an oak cask filled with water and grab on to metal rods immersed in the water. Mesmer would alternately chant, play a glass harmonium and wave his hands at the afflicted patients, who would twitch and cry out and sometimes even lose consciousness, whereupon they would be carried to a recovery room. One of the commissions in charge of investigating Mesmer’s claims was led by Benjamin Franklin, the U.S. ambassador to France at the time. The commission conducted a number of experiments with blindfolded patients. Over a period of a few months they tested whether people experienced the effects of Mesmer’s magnetic therapy even when they couldn’t see. Eventually the commission [concluded in its report](https://archive.org/stream/b22393857#mode/2up) “that the imagination is the true cause of the effects attributed to the magnetism.”  *Benjamin Franklin’s Report on Mesmerism*