Quick links from the past week in mind and brain news: NPR has a good piece on the vagaries of analysing functional brain scans. Philosopher Pete Mandik features Mind Hacks as a ‘Top 10 mind and brain blog’ for blogs.com. Shakira yet to call. The Ind…

Hard data is a lot closer to fact than is ideological speculation.

That is not correct.

The nature and size of the placebo/nocebo effect is still not clear. The work of Hróbjartsson and Gøtzsche in the last few years has raised serious questions about the conventional view of this phenomenon, and indeed its very existence (at least in some situations in which it was previously assumed to be in operation). While their work is by no means the final word, its full implications have yet to sink in for medical science and clinical practice.

As somebody who is quite familiar with an area of medicine where notions of nocebo are frequently thrown around, I find the profession’s often hasty, uncritical, and convenient use of this concept a little disturbing. A fair chunk of bad medical theory and practice is covered up by invoking placebo/nocebo, with no proof at all offered for the specific invocation, especially in the clinic.

It really is not justified to assume that placebo/nocebo occurs in any given situation, or that its effect is clinically significant, especially on a sustained basis. Applying notions of placebo effect in clinical practice is probably unethical at this point.

This is one fad clinicians should be very wary of succumbing to.

(And to be blunt, from behind the safety of internet anonymity, I am not that impressed by the work of Barsky and Borus. I think a lot more critical an appraisal of their views is required. I find their stuff quite ideological at times. More hard data, and less speculation, please.)

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Maimonides recommended in his Treatment of Sexual Disorders urinating into a hollow carrot as a cure for impotence. Well into the 17th century, the London Pharmacopoeia (as much of an authority as existed then) listed among its medicinal agents such things as the saliva of a fasting man, lozenges of dried viper, fox lungs and shed snake’s skin and sutures of the skull of an executed criminal among others.

In 1939, long before high-tech drugs came along to treat the chest pain known as angina, an Italian surgeon named Fieschi devised a simple technique. Reasoning that increased blood flow to the heart would ease his patients’ pain, he made tiny incisions in their chests and tied knots in two arteries. The results were spectacular. Three quarters of all patients improved.” One third were cured.

http://singyourownlullaby.blogspot.com/2009/06/placebo-effect.html