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Dylan Evans. Placebo: Mind over Matter in Modern Medicine
P L A C E B O. Mind Over Matter in Modern Medicine. Dylan Evans
PRAISE
CONTENTS
PREFACE
PREFACE TO THE PAPERBACK EDITION
Chapter 1 PLACEBOS ON TRIAL
PLACEBOS BECOME RESPECTABLE
THE LONG BIRTH OF THE CLINICAL TRIAL
THE PLACEBO CONTROL
A FLAW IN THE METHOD
THE LIVES TO COME
MIND-BODY MEDICINE
PLACEBOS AND CANCER
NO EVIDENCE?
THE HIERARCHY OF EVIDENCE
Chapter 2 WHAT CAN PLACEBOS REALLY DO?
THE POWERLESS PLACEBO
NATURAL BORN PAINKILLERS
KINDS OF PAIN
ALL IN THE MIND?
ULCERS
PLACEBOS AND MENTAL DISORDER
WHAT ABOUT DEPRESSION?
PLACEBOS AND SCHIZOPHRENIA
THE LIMITS OF THE PLACEBO RESPONSE
Chapter 3 THE ACUTE PHASE RESPONSE
THE ACUTE PHASE RESPONSE
PAIN
SWELLING
FEVER
LETHARGY, APATHY AND LOSS OF APPETITE
PLACEBO-RESPONSIVE CONDITIONS AND THE ACUTE PHASE RESPONSE
THE PARADOXES OF CORTISOL
ENDORPHINS
THE OTHER SIDE OF IMMUNITY
CHECKS AND BALANCES
EXPLAINING THE LIMITS OF THE PLACEBO RESPONSE
NAUSEA, FEVER AND LETHARGY
HEART DISEASE REVISITED
Chapter 4 THE BELIEF EFFECT
TRACING THE CHAIN BACK TO THE BRAIN
DOPAMINE AND PARKINSON’S DISEASE
THE PSYCHOLOGICAL LEVEL OF DESCRIPTION
REAL DRUGS AND HORSESHOES
SAYING IS BELIEVING
RECONSTRUCTING BELIEFS
THE BELIEF EFFECT
TESTING THE BELIEF THEORY
CONDITIONING
THE ELUSIVE PLACEBO REACTOR
THE CLINICAL CONTEXT
UNCONSCIOUS COMMUNICATION
BELIEF AND MAGIC
Chapter 5 WHY? THE EVOLUTIONARY QUESTION
WHY?
FUNCTION OR BY-PRODUCT?
IMMUNE CONDITIONING
PLACEBOS FOR RATS?
THE EVOLUTION OF IMMUNE CONDITIONING
THE ORIGINS OF IMMUNITY
THE PREHISTORY OF MEDICINE
PAIN AS A NEED STATE
EXTENDING THE IDEA
IMMUNE TRAFFICKING
HUMPHREY’S REMEDY
Chapter 6 NOCEBO – BEYOND GOOD AND BAD
THE SIDE-EFFECTS OF PLACEBOS
WHEN BELIEF KILLS
THE AMBIGUITY OF HEALTH AND DISEASE
THE TOXIC THEORY OF MEDICINE
FEVER PHOBIA
WHEN DOES PAIN STOP BEING A GOOD THING?
THE BENEFITS OF STOMACH ULCERS
THE BENEFITS OF THE BLUES
THE ORIGINS OF STRESS
Chapter 7 THE ALTERNATIVES
THE EVIDENCE FOR ALTERNATIVE AND COMPLEMENTARY MEDICINE
ARE CLINICAL TRIALS BIASED AGAINST ALTERNATIVE MEDICINE?
HOMEOPATHY: A SPECIAL CASE
IT’S JUST A PLACEBO – BUT SO WHAT?
THE MEGA-PLACEBO EFFECT
TIME AND RITUAL
HEALING WITH HANDS
SEPARATING THE WHEAT FROM THE CHAFF
Chapter 8 PSYCHOTHERAPY – THE PUREST PLACEBO?
PUTTING PSYCHOTHERAPY TO THE TEST
IS PSYCHOTHERAPY JUST A PLACEBO?
WOULD IT MATTER IF PSYCHOTHERAPY WAS PURE PLACEBO?
A PANOPLY OF THEORIES
THE THEORY OF REPRESSION
BEHAVIOUR THERAPY
THE VALUE OF PSYCHOTHERAPY
Chapter 9 THE WITCH DOCTOR’S DILEMMA
PLACEBOS WITHOUT DECEPTION?
A SHAMAN’S TRICKS
BECOMING MORE OPEN
BEING ECONOMICAL WITH THE TRUTH
WHEN PLACEBOS ARE NOT JUSTIFIED
THE USE OF PLACEBOS IN CLINICAL TRIALS
SHAM SURGERY
PROTECTING THE PUBLIC
CONCLUSION
BIBLIOGRAPHY
INDEX
ACKNOWLEDGEMENTS
ABOUT THE AUTHOR
NOTES
BY THE SAME AUTHOR
COPYRIGHT
ABOUT THE PUBLISHER
Отрывок из книги
From the reviews of Placebo:
‘The placebo effect is fundamental to medical treatment, and this book brilliantly explores the scientific evidence in an accessible and gripping manner’
.....
To be consistent, we should apply the same rigorous scientific principles to the study of placebos that we apply to the evaluation of real treatments. No scientist would accept claims advanced on behalf of a new drug without evidence that people who are treated with it are at least more likely to get better than those who remain untreated. It should be no different when it comes to the claims made on behalf of placebos. In other words, to calculate the true placebo effect, the rate of spontaneous remission shown by those receiving no treatment at all must be subtracted from the observed placebo effect. Without a no-treatment arm, there is no way to distinguish the effects of the placebo from the natural course of the disease and various other confounding variables, such as other treatments taken outside the context of the trial.
In fact, no-treatment groups are rarely included in clinical trials today. One survey of the medical literature between 1986 and 1994 found that fewer than 4 per cent of clinical trials and meta-analyses published during that period included both placebo and untreated groups.16 The result is that, despite half a century of placebo-controlled clinical trials, we have surprisingly little solid data about the extent of the placebo response. The lack of such data has even led a few sceptics to argue that the placebo response does not really exist. They claim that the improvement shown by patients receiving placebos in clinical trials is due entirely to spontaneous remission and random fluctuations in the course of the disease.17
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