The Placebo Effect: An Interdisciplinary Exploration

A mere "symbol" of medicine—the sugar pill, saline injection, doctor in a white lab coat—the placebo nonetheless sometimes produces "real" results. Medical science has largely managed its discomfort with this phenomenon by discounting the placebo effect, subtracting it as an impurity in its data through double-blind tests of new treatments and drugs. This book is committed to a different perspective—namely, that the placebo effect is a "real" entity in its own right, one that has much to teach us about how symbols, settings, and human relationships literally get under our skin.

Anne Harrington's introduction and a historical overview by Elaine Shapiro and the late Arthur Shapiro, which open the book, review the place of placebos in the history of medicine, investigate the current surge in interest in them, and probe the methodological difficulties of saying scientifically just what placebos can and cannot do. Combining individual essays with a dialogue among writers from fields as far-flung as cultural anthropology and religion, pharmacology and molecular biology, the book aims to expand our ideas about what the placebo effect is and how it should be seen and studied. At the same time, the book uses the challenges and questions raised by placebo phenomena to initiate a broader interdisciplinary discussion about our nature as cultural animals: animals with minds, brains, and bodies that somehow manage to integrate "biology" and "culture," "mechanism" and "meaning," into a seamless whole.

Elizabeth C. Penick

This splendid small book is the product of a 1994 conference on the placebo that was chaired by the editor, who is also Professor of the History of Science at Harvard. It contains a fine introduction, nine well-edited chapters by leaders in the field, and a transcript of dialogue that occurred among the contributors and other participants at the conference. The book provides a broadly focused introduction to, and historical review of, the placebo in the practice of medicine. All practitioners and students in health-related fields should find something to intrigue them, and possibly amaze them, in this very useful book. The editor points out that ""Placebo is Latin for 'I shall please' and is the opening phrase of the Catholic vespers for the dead, from which the medical term, ironically enough, is derived."" She remarks that ""Placebos are the ghosts that haunt our house of biomedical objectivity...."" The late Arthur Shapiro and his wife Elaine provocatively assert that, ""The panorama of treatment since antiquity provides ample support for the conviction that, until recently, the history of medical treatment is essentially the history of the placebo effect."" The chapters that follow review the placebo response in specific areas of study (i.e., pain reduction), conditioning, and the influence of cultural symbols on illness and physical suffering. This is a marvelously informative and interesting book that is likely to serve as the standard work on the placebo effect for many years.

Anne Harrington is Loeb Harvard College Professor and Professor for the History of Science at Harvard University.