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The origin of the Legend of Placebo

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

I’ve been reading old scientific papers. This is the bottom line of the 1955 paper that launched the Legend of Placebo:

Dr. Henry Beecher reported that 35% of 1000 patients were “satisfactorily” treated with a placebo alone. His conclusion catapulted placebo to lasting fame… and that wasn’t really questioned for a long time.

In 1996, Kienle and Kiene published a strong criticism of Beecher’s findings, but no one took much notice.

In 2001, Hróbjartsson and Gøtzsche made a much bigger splash: they reported in the New England Journal of Medicine that they “found little evidence in general that placebos had powerful clinical effects” and concluded that there is “no justification for the use of placebos” outside clinical trials. (Notably, Hróbjartsson and Gøtzsche updated their paper in 2004.)

The topic has been hotly debated ever since, but few experts still believe that placebo is “powerful.” Interesting, certainly. Potent, not so much.

I’ve updated my main placebo article with this historical perspective: Placebo Power Hype. This post is just one small piece of the extensive work I am doing this year on the theme of the mind in pain. The alleged power of placebo is one of the biggest reasons that people believe that there might be relief in psychology. If you can be fooled into a cure, then sure you can psychologize your way into one, right? Or meditate? Or de-stress?

But all that hope is based on the crumbling foundation of the Legend of Placebo! Ruh roh.

For much more about Beecher and how this all started, see The Legend of the Wartime Placebo.

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