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No. 128: MAR-APR 2000

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Fake Needles but Real Knives

The effect of a patient's mind in medical procedures can be as powerful as drugs and real surgery. This is the well known placebo effect. But how can doctors differentiate between the healing power of the mind and that of chemicals and scalpels? The logical thing to do is to fake the procedure with one group of patients and compare results with a second group that got the "real thing." Of course, ethical problems come to the fore because doctors are supposed to cure people and not to pretend to. The ethical dimension is accentuated when real knives are employed and real blood flows.

Our first item is not invasive but interesting nonetheless.

Placebo acupuncture. Many physicians scoff at acupuncture. Placebo experiments could prove its efficacy. To this end, special placebo needles have been invented. Like the fake daggers used on the stage, the points are blunt and retractable. The acupuncture patient feels a pinprick and thinks he or she sees the needle penetrating the skin, but it's all fakery.

At the University of Heidelberg, 52 people with rotator cuff tendinitis were split into two groups; 25 were punctured with real needles, the rest just thought they were. In this experiment, the first group showed much greater improvement than those treated with the fake needles. Real acupuncture was more powerful than the placebo effect.

Now if we can only figure out how real acupuncture works!

(Lawton, Graham; "Needle Match," New Scientist, p. 10, December 4, 1999.)

Placebo surgery. Because of the ethical questions, placebo surgery went out of style 40 years ago. A revival is now underway. One promising treatment for Parkinson's disease requires the drilling of holes in the patient's forehead and injecting fetal cells deeply in the brain. This is certainly a far cry from the fake acupuncture needles!

One patient, who knew she was involved in a placebo experiment, was lightly sedated during the real drilling. After the holes were completed, she heard the surgeon ask for the fetal-cell implants. Because of this, she was certain she had received the complete procedure. Afterwards, she felt that her condition had definitely improved. But it was all a charade. The doctor did not insert the implants. Her symptoms soon returned. The placebo effect was only temporary.

However, some of the younger patients who did get the total procedure did receive permanent benefits. The doctors knew, therefore, that the procedure holds out some promise.

(Cohen, Philip; "All in the Mind," New Scientist, p. 18, August 7, 1999.)

From Science Frontiers #128, MAR-APR 2000. � 1997 William R. Corliss

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