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I would speculate that when placebos appear to work, it is primarily because they don't do anything, besides possibly providing some increased hope to the patient, allowing the body to work without the "side" effects of drugs. The human body naturally tries to heal itself to the best of its ability.

Here's a very interesting example of placebos being administered on a routine basis, for years.

  Natural Hygiene, as it is today, can be traced back to Dr Isaac
  Jennings (of Oberlin, Ohio, USA) who, after practising medicine for 20
  years, began to ask questions when, during a fever outbreak in the
  summer of 1815, a patient who rested, drank water and did nothing,
  recovered in absolute record time compared to patients who had been
  medicated. Based on this, Dr Jennings noted similar results with many
  other patients.

  He then went on to treat many patients with what must have been one
  of the first placebo (dummy pill) treatments. In 1822 he gave up
  medical pills, plasters, powders and potions and treated patients with
  pills made from bread and vegetable-coloured water for the next 20
  years. This he only did to keep the patients’ confidence in him. He
  would then advise his patients to correct their lifestyle and diet to
  a more natural approach. He then practised for a further 20 years the
  "do nothing mode of treating disease." He wrote three books, "Medicine
  Reform" (1847), "Philosophy of Human Life" (1852) and "Tree of Life"
  (1867).

  Natural hygiene was often referred to at this stage as Orthopathy
  meaning TRUE or RIGHT AFFECTION or BEHAVIOUR.

  Dr Jennings had a great influence upon Dr R T Trall, who went on to
  do more for the hygiene movement than any man, next to Dr Herbert
  Shelton.
http://www.mary-anns.com/Natural%20Hygiene.htm

I've read this account on other sites as well. The Jennings story can be verified by other sources online. His deliberate use of placebo for so many years is fascinating.

More information here on Jennings: http://naturalhygienesociety.org/past2.html




I would speculate that when placebos appear to work, it is primarily because they don't do anything

I like your argument but, amazingly, there's some research that seems to indicate that placebos affect a physical change. In cases where heroin was used as a pain killer, a placebo could be blocked using the same chemical that blocks the effect of heroin.

Here's more: http://www.newscientist.com/article/dn7892


And as a further consequence -- real naloxone blocks the effects of placebo morphine.

http://news.ycombinator.com/item?id=567913


You have to bear in mind that before the germ theory of disease (late 19th century) and then penicillin (mid 20th century) doctors didn't know what was causing most disease, and couldn't do anything about it if they did.

Homeopathy hangs around today partly because for many years it provided an alternative to mainstream medicine that was more likely to kill than cure you. The standard 'medicines' were leeches, bleeding, laxatives and emetics to make you throw up. Magic water was, at that time, a sensible alternative by comparison.




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